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摘要: 目的 探讨高频电刀在永久性心脏起搏器植入术及更换术中的安全性。方法 观察永久性心脏起搏器植入术及更换术中应用高频电刀对术后囊袋血肿发生的影响，对更换起搏器者随访观察电极参数的变化情况。结果 高频电刀在344例起搏器植入或更换患者中囊袋血肿发生率为0。在6个月~1年随访期间，更换起搏器的患者电极的阈值、感知及阻抗均正常，且各参数前后变化无统计学差异。结论 高频电刀在起搏器植入及更换术中应用安全、可靠。Abstract: Objective To explore the safety of high frequency electrosurgical equipment of implantation and replacement of permanent cardiac pacemaker.Methods We observed the effect of high frequency electrosurgical equipment of the occurrence of postoperative pocket hematoma during pacemaker implantation and replacement, and understood the changes of electrode parameters of pacemaker changers.Results The incidence of pocket hematoma in 344 patients with pacemaker implantation or replacement was 0. During the follow-up period from six months to one year, wave amplitude, threshold and impedance of the pacing system of patients with pacemaker replacement were normal, and there was no significant difference in parameter changes.Conclusion It is safe and reliable to use high frequency electrosurgical equipment in pacemaker implantation and replacement.
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Key words:
- pacemaker /
- high frequency electrosurgical equipment /
- pocket hematoma
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表 1 基线资料
Table 1. General data
例(%), X±S 项目 电刀组(344例) 对照组(769例) P 年龄/岁 68±14 63±14 < 0.001 男性 207(60.2) 408(53.1) 0.027 冠心病 83(24.1) 房颤 98(28.5) 高血压 134(39.0) 糖尿病 67(19.5) 82(10.7) < 0.001 肾功能不全 11(3.4) 7(0.9) 0.001 脑梗死 33(9.6) 起搏器植入病因 病窦 82(23.8) 传导阻滞 126(36.6) 心功能不全 40(11.6) 室性心动过速 23(6.7) 起搏器更换 80(23.3) 起搏器植入种类 < 0.001 单腔起搏器 41(11.9) 327(42.5) 双腔起搏器 214(62.2) 402(52.3) 三腔起搏器 12(3.5) 27(3.5) 单腔/双腔/三腔ICD起搏器 77(22.4) 13(1.7) 用药情况 < 0.001 抗凝药物 73(21.2) 52(6.8) 抗血小板聚集药物 67(19.5) 无抗凝或抗血小板药 154(44.8) 
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表 2 起搏器更换电极情况
Table 2. Electrode replacement of pacemaker
X±S 使用时 6个月后随访 P 心房感知(54) 0.7±0.4 0.7±0.3 0.69 心房阈值(59) 3.2±2.3 3.1±2.1 0.10 心房阻抗(56) 579±188 553±155 0.11 右心室阈值(72) 0.95±0.58 0.97±0.10 0.38 右心室感知(65) 12.1±5.8 11.7±5.1 0.29 右心室阻抗(72) 621±180 611±156 0.40 左心室阈值(14) 1.2±0.4 1.2±0.3 0.31 左心室感知(4) 11.2±2.6 9.4±1.9 0.41 左心室阻抗(14) 762±205 712±199 0.18
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| 引用本文: |
张学丹, 刘兵, 胡淼阳, 等. 高频电刀在永久性心脏起搏器术中的应用[J]. 临床心血管病杂志, 2023, 39(6): 471-473. doi: 10.13201/j.issn.1001-1439.2023.06.012
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| Citation: |
ZHANG Xuedan, LIU Bing, HU Miaoyang, et al. Application of high frequency electrosurgical equipment of pacemaker surgery[J]. J Clin Cardiol, 2023, 39(6): 471-473. doi: 10.13201/j.issn.1001-1439.2023.06.012
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