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目的探讨起搏器囊袋破溃的常见原因及合理的处理方法。方法通过回顾性分析我院心血管内科2007年1月至2011年3月的12例起搏器囊袋破溃的基本资料,比较不同处理措施的临床疗效。结果①12例患者平均年龄75.3岁,男性7例,女性5例,其中11例合并高血压、心衰及糖尿病。3例为早发型、9例为迟发型囊袋破溃。②随访(31.6±6.8)个月。8例在对侧安置新的起搏系统,2例取出原起搏器,2例原电极与原起搏器被深埋在患侧胸大肌深面。所有患者新的起搏系统工作良好。③所有患者原电极未拔除。6例残余电极前浅埋皮下者,半数残余电极刺破皮肤。4例残余电极和2例原电极深埋者,均达到完全痊愈。结论起搏器囊袋破溃原因复杂,加强局部清创、深埋残余电极等可获得较好的疗效。
Objective To explore the common causes of pouch pouch rupture and reasonable treatment. Methods The clinical data of 12 cases of pacemaker pouch rupture from January 2007 to March 2011 in our hospital were analyzed retrospectively to compare the curative effect of different treatment measures. Results ① The average age of 12 patients was 75.3 years. There were 7 males and 5 females. Eleven of them were complicated by hypertension, heart failure and diabetes. 3 cases of early hair type, 9 cases of delayed type capsular rupture. ② Follow-up (31.6 ± 6.8) months. Eight patients received a new pacing system on the contralateral side. Two patients had their pacemaker removed. Two patients with primary pacemaker and deep pacing were deeply buried in the affected pectoralis major. The new pacing system works well for all patients. ③ all patients without removal of the original electrode. 6 cases of residual electrodes before the shallow subcutaneous, half of the remaining electrodes pierce the skin. 4 cases of residual electrodes and 2 cases of the original electrodes buried, were completely cured. Conclusion Pacemaker pouch ulceration causes complex, to strengthen the local debridement, deep residual electrode can get better curative effect.