摘要
目的 观察以抗生素液冲洗起搏器囊袋的操作对囊袋和切口感染的预防作用。方法 1 1 8例病人分为抗生素液囊袋预防组和生理盐水对照组 ,其它手术操作方法完全相同。起搏导线全部经锁骨下静脉穿刺途径植入 ,起搏器囊袋位于左或右前上胸部皮下。术后第 1、3、5d分别更换敷料 1次 ,第 1 0d拆线出院。术后 3个月、1年、3年、5年、7年常规随访 ,观察手术切口和囊袋情况。结果 围手术期发生囊袋积血 6例 ,其中预防组 4例 ,对照组 2例 ,年龄都在 70岁以上 ,经抽吸和静脉滴注白蛋白后很快消失。对照组 1例术后第 5d发生囊袋内脂肪液化 ,经抽吸后 1 0d痊愈。两组病人在围手术期和整个随访期间均未发生囊袋或切口感染 ,亦无再次手术病例。结论 采用小切口血管穿刺技术植入永久性心脏起搏器时 ,在关闭切口前常规采用抗生素液冲洗囊袋和切口对围手术期囊袋感染发生率无明显影响。
ObjectiveThe purpose of the study is to evaluate the infection preventative e ffect of antibiotic saline flushing in the pacemaker pocket during the implant ation procedure.MethodsOne hundred and eighteen patients with pacemaker implantation indications w ere randomized into preventative group (PG, with antibiotic solution to flush p acemaker pocket during procedure) and control group (CG, with normal saline to flush the pocket). All pacing leads were inserted via subclavian approach b y Seldinger technique. Pacemaker pockets were made subcutaneously at either left or right anterior superior chest. Follow-up was conducted in 3 months, 1,3,5 and 7 years after pacemaker implantation. Results Six cases of p ocket blood accumulati on (4 in PG and 1 in CG) were observed during perioperative period. They were eliminated by drainage and intravenous albumin. One patient in CG had fattiness liquefication in the pocket at fifth day after operation. No patient in both gro ups had local and systematic infection during follow-up. Conclusi ons Pacemaker poc ket flushing with antibiotic solution to prevent infection is not necessary whe n the Seldinger technique is used in cardiac pacemaker implantation. Strict asep tic operative procedure is the key point to prevent perioperative pacemaker pock et infection.
出处
《中华心律失常学杂志》
2003年第2期100-102,共3页
Chinese Journal of Cardiac Arrhythmias
