2019 年第 11 期 第 14 卷

心脏瓣膜术后永久心脏起搏器的临床应用

Clinical application of permanent cardiac pacemaker implantation after cardiac valve surgery

作者：赵战勇吴翔宇王茜李宁张京梅李志忠

英文作者：

单位：100029首都医科大学附属北京安贞医院心内科十五病房

英文单位：

关键词：心脏瓣膜手术；房室传导阻滞；永久心脏起搏器

英文关键词：

• 摘要：

• 【摘要】目的    分析心脏瓣膜术后永久心脏起搏器植入的方法和策略，评价手术的安全性和有效性。方法    回顾性分析2008年1月至2018年1月首都医科大学附属北京安贞医院心脏瓣膜手术后行永久心脏起搏器植入手术11例患者的临床资料，外科手术到永久心脏起搏器植入5～21 d，平均（11±5）d。永久心脏起搏器植入术后即刻、1个月和1年门诊随访，复查起搏器参数。随访时观察起搏器并发症发生情况。结果    11例患者均成功植入永久心脏起搏器，其中双腔起搏器9例，单腔起搏器2例。心室主动电极植入8根，心室被动电极植入3根；心房主动电极植入4根，心房被动电极植入5根。11例起搏器植入患者术中未发生严重出血，术后1例囊袋血肿，给予穿刺抽出淤血并加压包扎后血肿消失。起搏器植入术后即刻、1个月和1年电极参数均无明显变化（均P＞0.05）。结论    心脏瓣膜术后早期永久心脏起搏器的植入安全有效。

• 【Abstract】Objective    To analyze the Methods     and strategies, safety and effectiveness of permanent cardiac pacemaker implantation after cardiac valve surgery. Methods    From January 2008 to January 2018, 11 patients underwent permanent cardiac pacemaker implantation after heart valve surgery in Beijing Anzhen Hospital, Capital Medical University. Surgery to pacemaker implantation time was 5-21 d and the mean time was (11±5)d. Pacemaker parameters were examined immediately, 1 month and 1 year after implantation. Complications of pacemaker implantation were observed during follow-up. Results    All patients were successfully implanted with permanent cardiac pacemaker, including 9 dual-chamber pacemakers and 2 single-chamber pacemakers. Eight ventricular active electrodes, 3 ventricular passive electrodes, 4 atrial active electrodes and 5 atrial passive electrodes were implanted. No severe bleeding occurred during implantation. One patient developed pocket hematoma after operation, which disappeared after puncture, extraction of congestion and pressure bandaging. No significant changes in electrode parameters were observed immediately, 1 month and 1 year after pacemaker implantation(all P＞0.05). Conclusion    Permanent cardiac pacemaker can be safely and effectively implanted during the early period after cardiac valve surgery.