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目的探讨心脏植入式电子装置(CIED)囊袋感染后经上腔及下腔静脉途径拔除电极对CIED依赖患者装置再置入时间的影响,并分析其原因,提出改进策略。方法回顾性分析2015年因CIED感染就诊于北京大学人民医院心脏中心,并给予电极拔除的患者,选取其中单纯囊袋感染,因CIED依赖需行装置再置入的患者。根据拔除途径不同分为上腔组及下腔组,分析两组病例的基线资料,临床特征,电极拔除方式,术前术后体温、血常规、血培养结果,电极拔除后再置入CIED时间。评估不同电极拔除途径术后患者一般情况以及对再植入时机的影响。结果共入选95例单纯CIED囊袋感染患者,均成功行电极拔除,并择期行CIED再置入。与上腔组比较,下腔组电极植入年限较长[72(48,126)个月vs 12(8,24)个月,P<0.01],术后发热、血象升高增多[40.7%(22/54)vs 12.2%(5/41),61%(33/54)vs 4.9%(2/41),P均<0.05],CIED再置入时间延长[5(2,7)天vs 2(2,5)天,P<0.05],血培养阳性增多[3/54vs 0]。结论下腔静脉途径拔除电极延长再植入时间。
OBJECTIVE: To investigate the influence of extracapsular and inferior vena cava electrodes on the placement time of CIED-dependent patients after capsular electronic device (CIED) capsular infection and to analyze the causes and propose improvement strategies. Methods A retrospective analysis of patients with CIED infection who visited Peking University People’s Hospital Cardiac Center in 2015 and patients with electrode extraction were retrospectively analyzed. Patients with simple capsular bag infection and re-implantation due to CIED-dependent need were selected. Baseline data, clinical features, mode of electrode extraction, preoperative and postoperative postoperative body temperature, blood routine and blood culture results were analyzed according to different ways of removal. The electrodes were removed and then placed in CIED time . Evaluate the general condition of patients with different electrode removal routes and the timing of replantation. Results A total of 95 patients with CIED capsular infection were enrolled. Electrodes were successfully removed and replaced with CIED. Compared with the upper chamber group, the lower chamber electrode implantation time longer [72 (48,126) months vs 12 (8,24) months, P <0.01], postoperative fever, increased blood increased [40.7% (22 / 54) vs 12.2% (5/41), 61% (33/54) vs 4.9% (2/41), all P <0.05] (2, 5) days, P <0.05], blood cultures were positively elevated [3/54 vs 0]. Conclusion The removal of the inferior vena cava electrode prolongs the time of replantation.