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目的起搏器囊袋感染是起搏器置入术后常见的并发症之一,严重者可以并发心内膜炎而危及生命。本研究针对囊袋感染的治疗及效果进行了总结。方法纳入2002年至2008年院内顺序收治的52例起搏器囊袋感染患者。分析影响首次手术即发生囊袋感染的危险因素和囊袋感染首次治疗后复发的危险因素。结果共入选起搏器囊袋感染患者52例,平均年龄60.6±17.2岁,男性31例。53.9%患者置入双腔起搏器,30.8%合并2型糖尿病;末次手术距首次诊断囊袋感染的平均间隔时间为571.9±790.8天,其中42.3%的患者首次囊袋感染发生于末次手术1年以上。50%的患者为首次置入起搏系统后出现囊袋感染,这些患者置入双腔起搏器的比例有高于二次手术后发生感染患者组的趋势(p=0.06),包括年龄在内的其他临床特征没有显示出统计学差异。Logistic回归分析发现首次诊断感染患者进行清创术后复发的危险性仅与是否移除整套起搏系统这一治疗措施呈负相关(RR0.11,95%CI,0.02-0.51,p<0.01)。结论针对起搏器术后囊袋感染的处理只有完全移除整套起搏系统才是真正有效地治疗方法。
Pacemaker Pouch infection is one of the most common complications after implantation of pacemaker. In severe cases, endocarditis can be endangering life. This study summarizes the treatment and effect of capsular infection. Methods Fifty-two patients with pacemaker pouch infection admitted to our hospital from 2002 to 2008 were enrolled. To analyze the risk factors that affect the first operation of the capsular bag infection and the risk factors of recurrence after the first treatment of the capsular bag infection. Results A total of 52 patients were selected as pacemaker capsular infection, with an average age of 60.6 ± 17.2 years and 31 males. 53.9% patients had double-chamber pacemaker and 30.8% had type 2 diabetes mellitus. The average time between the last operation and the first diagnosis of capsular infection was 571.9 ± 790.8 days, of which 42.3% Years or more. In 50% of patients with capsular bag infection after the first placement of the pacing system, these patients had a higher rate of dual-chamber pacemakers than those who developed infection after secondary surgery (p = 0.06), including those aged < Other clinical features did not show statistical differences. Logistic regression analysis showed that the risk of relapse after debridement in patients with first diagnosis of infection was only negatively correlated with whether the whole pacing system was removed or not (RR 0.11, 95% CI, 0.02-0.51, p <0.01) . Conclusion The treatment of postoperative pacemaker pouch infection is a true and effective treatment only if the complete pacing system is completely removed.