CAJ | 학술논문

目的：评估植入电子装置（CIED）感染的治疗策略。方法回顾性分析本心脏中心1817例植入起搏器和除颤仪患者中出现CIED感染的病例，分析其临床表现和预后，探讨治疗方法。结果发生CIED感染16例（0.88%），其中起搏器囊袋感染15例（93.75%）。均进行起搏器囊袋清创聚维酮碘浸泡消毒。重置原起搏器于胸大小肌之间9例，复发6例（66.7%），显著高于取出原起搏器患者（12例，复发率为0）。取出原起搏器和保留起搏导管8例，取出原起搏器和经皮拔除起搏导管4例。无感染和拔管相关的死亡。CIED感染者相关住院次数、住院治疗天数为（2.4±0.5）次、（41±18）d，非感染者为（1.0±0.1）次、（13±3）d。结论完全移除CIED是成功治疗CIED感染的关键。若无并发导管相关感染，保留导管并不影响患者的预后。
목적：평고식입전자장치（CIED）감염적치료책략。방법회고성분석본심장중심1817례식입기박기화제전의환자중출현CIED감염적병례，분석기림상표현화예후，탐토치료방법。결과발생CIED감염16례（0.88%），기중기박기낭대감염15례（93.75%）。균진행기박기낭대청창취유동전침포소독。중치원기박기우흉대소기지간9례，복발6례（66.7%），현저고우취출원기박기환자（12례，복발솔위0）。취출원기박기화보류기박도관8례，취출원기박기화경피발제기박도관4례。무감염화발관상관적사망。CIED감염자상관주원차수、주원치료천수위（2.4±0.5）차、（41±18）d，비감염자위（1.0±0.1）차、（13±3）d。결론완전이제CIED시성공치료CIED감염적관건。약무병발도관상관감염，보류도관병불영향환자적예후。
Objective To evaluate treatment strategies in cardiac implantable electronic device(CIED) infection. Methods The treatment strategies and prognosis of CIED infection were retrospectively analyzed in 1 817 cases implanted with CIED. Results CIED infection occurred in 16 cases (0.88%). Of them, 15cases(93.75%) had pacemaker pocket infection. Al the pacemaker pockets were debrided and irrigated with povidone-iodine. The original pacemaker was re-implanted between the pectoralis major and minor muscles in 9 cases, of them, re-infection of CIED occurred in 6 cases (66.7%). No infection occurred again in 12 cases with the pacemakers removed. 8 cases had pacemakers removed and pacing leads left in place. 4 cases had pacemakers removed and pacing leads extracted percutaneously. There was no death due to infection and lead extraction. The hospitalization time and hospital stay were 2.4±0.5 and 41±18days, respectively, in patients with CIED infection and 1.0±0.1 and 13± 3days in patients without CIED infection. Conclusion Removing CIED is the key to successful treatment of CIED infection. The lead left in place may not affect the prognosis if without lead-associated infection.