CAJ | 학술논문

目的分析老年患者永久性心脏起搏器植入术后起搏器囊袋感染的相关因素,为预防术后囊袋感染提供理论依据. 方法收集心内科2010年4月至2013年6月择期行永久性心脏起搏器植入术老年患者412例的临床资料,分析术后起搏器囊袋感染情况及其相关因素. 结果 5例(1.2％)发生囊袋感染,囊袋感染患者的平均年龄(74.5±4.2)岁,高于未感染患者(60.3±6.6)岁,差异有统计学意义(t=4.781,P＜0.01).手术次数≥2次和＜2次患者囊袋感染率分别为10.0％(3/30)和0.5％(2/382),差异有统计学意义(x2=10.583,P＜0.01).手术时间≥2h和＜2 h患者囊袋感染率分别为3.8％(4/106)和0.3％(1/306),差异有统计学意义(x2=7.802,P＜0.01).囊袋血肿患者囊袋感染率为16.7％(3/18),高于无囊袋血肿患者0.5％(2/394),差异有统计学意义(x2=37.492,P＜0.01).囊袋血肿(OR=6.193)、手术次数≥2次(OR=2.594)、手术时间≥2 h(OR=2.265)和年龄≥75岁(OR=2.193)为囊袋感染的独立危险因素(P＜0.05或0.01). 结论老年患者永久性心脏起搏器植入术后起搏器囊袋感染与囊袋血肿、手术次数、手术时间和年龄有关.
목적 분석노년환자영구성심장기박기식입술후기박기낭대감염적상관인소,위예방술후낭대감염제공이론의거. 방법 수집심내과2010년4월지2013년6월택기행영구성심장기박기식입술노년환자412례적림상자료,분석술후기박기낭대감염정황급기상관인소. 결과 5례(1.2％)발생낭대감염,낭대감염환자적평균년령(74.5±4.2)세,고우미감염환자(60.3±6.6)세,차이유통계학의의(t=4.781,P＜0.01).수술차수≥2차화＜2차환자낭대감염솔분별위10.0％(3/30)화0.5％(2/382),차이유통계학의의(x2=10.583,P＜0.01).수술시간≥2h화＜2 h환자낭대감염솔분별위3.8％(4/106)화0.3％(1/306),차이유통계학의의(x2=7.802,P＜0.01).낭대혈종환자낭대감염솔위16.7％(3/18),고우무낭대혈종환자0.5％(2/394),차이유통계학의의(x2=37.492,P＜0.01).낭대혈종(OR=6.193)、수술차수≥2차(OR=2.594)、수술시간≥2 h(OR=2.265)화년령≥75세(OR=2.193)위낭대감염적독립위험인소(P＜0.05혹0.01). 결론 노년환자영구성심장기박기식입술후기박기낭대감염여낭대혈종、수술차수、수술시간화년령유관.
Objective To analyze related factors for pacemaker pocket infection in elderly patients after implantation of permanent pacemakers and to provide a theoretical basis for preventing pacemaker pocket infection.Methods Pacemaker pocket infection and related factors were analyzed for 412 patients who received implantation of permanent pacemakers from Apr.2010 to Jun.2013 in the Department of Cardiology.Results With 5 cases of pacemaker pocket infection,the rate of infection was 1.2％.The infected patients were older than the uninfected patients [(74.5±4.2) years vs.(60.3±6.6) years,t=4.781,P＜0.01].The rate of infection was higher in patients who had undergone operations twice or more than in patients who had undergone one operation [10.0％ (3/300) vs.0.5％ (2/382),x2=10.583,P＜0.01].The rate of infection was higher in patients with the operation lasting 2 hours or longer than in patients with the operation time shorter than 2 hours [(3.8％ (4/106) vs.0.3％ (1/306),x2=7.802,P＜0.01].The rate of infection was higher in patients with pocket hematoma than in patients without pocket hematoma [16.7％ (3/18) vs.0.5％(2/394),x2=37.492,P＜0.01].Independent risk factors for pacemaker pocket infection included pocket hematoma (OR=6.193),number of operations≥2 (OR=2.594),operating time≥2 hours (OR=2.265) and age of 75 years or older (OR =2.193).Conclusions Pocket infection after implantation of permanent pacemakers is related to pocket hematoma,number of operations,operating time and age.