摘要
目的回顾性分析起搏器相关感染的临床特征，评价起搏系统感染的治疗方法及其预后。方法选择自2002年1月至2009年12月的所有因“起搏系统相关感染”入院的患者，回顾性分析起搏器相关感染的临床特点、治疗及预后。结果共58例起搏器相关感染的患者纳入研究。单纯起搏器囊袋局部感染52例，合并全身感染6例。与同期住院的所有起搏器患者相比较，起搏器感染的发生率为0．93％，其中起搏器首次植入感染的发生率为0．69％，更换后的感染发生率为1．96％（P〈0．01）。治疗上，6例仅静脉使用抗生素及局部换药；其余52例患者，38例行局部清创（清创组）；14例行整个起搏系统移除与清创（导线拔除组）。结果发现清创组21例（55．2％）感染复发，导线拔除组仅1例（7．7％）复发，（P〈0．001）。40例患者在起搏器移除后再次评价，其中16例（40％）未再植入新的起搏器。结论起搏系统相关感染是起搏器植入的严重并发症，起搏器更换为感染的危险因素之一。单纯局部清创感染复发风险很高，导线拔除并移除整个起搏系统是最佳的治疗方法。术后须进一步评价患者的起搏器适应证。
Objective To describe the clinical characteristics and management of the pacemaker related infections. The management methods can affect the prognosis of the infections. Methods We retrospectively identified cases of pacemaker infections in our hospital between Jan 2002 and Dec 2009. The clinical character- istics, management and prognosis were analyzed. Results A total of 4972 permanent pacemakers were implan- ted. Fifty-eight cases of confirmed pacemaker related infections were enrolled, among those 46 cases were im- planted in our center,giving an infection rate of 0. 93%. The infection rate in the patients with de-novo implan- tation was 0. 69% ,and the one in the patients with generator replacement was 1.96% （ P〈0. 01 ）. Median time from implantation to infection presentation was 16 months. 52 patients presented with generator-site infection, 6 patients presented with systematic infection. Complete device extraction occurred in 14 cases, of which only one relapsed（7.7% ）;with 38 partial removal patients,relapse occurred in 21 cases（55.2% ,P〈O. 001 ）. Re-im- plantation of a new device only occurred in 60% of all these patients. Conclusions Pacemaker related infec- tion is a most serious comphcatian, and generator replacement is one of the risk factors. Complete device and lead removal resulted in the best outcomes for the patients.
出处
《中华心律失常学杂志》
2012年第3期168-171,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
起搏器
囊袋感染
系统感染
Pacemaker
Generator-site infection
Systematic infection
