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目的分析高龄老年人安置心脏永久起搏器的临床特点及并发症治疗。方法12例高龄老年患者,年龄80~96岁。心律失常类型分别为快-慢综合征6例,Ⅱ度Ⅱ型以上房室传导阻滞4例,窦性停搏2例。安置起搏器类型:DDDR 1例,DDD 5例,VVIR 4例,VVI 2例。结果(1)高龄老年患者心内膜阻抗增高。12例高龄老年患者心内膜阻抗870~1 460Ω。(2)3例85岁以上高龄老年患者术后1周后活动上肢导致起搏器囊袋内出血皮下血肿,发现后局部压迫和上肢制动,均自行吸收痊愈。(3)4例发生术中恶性心律失常。结论高龄老年人由于生理性衰老变化,在安置心脏永久起搏器的过程中及术后易发生手术并发症,临床治疗中应加以重视。
Objective To analyze the clinical features and complications of permanent cardiac pacemakers in the elderly. Methods 12 cases of elderly patients, aged 80 to 96 years old. Arrhythmia types were fast-slow syndrome in 6 cases, Ⅱ degree Ⅱ type more than 4 cases of atrioventricular block, sinus arrest in 2 cases. Pacemaker placement type: DDDR in 1 case, DDD in 5 cases, VVIR in 4 cases, VVI in 2 cases. Results (1) The elderly elderly patients with increased endocardial impedance. Endocardial impedance was 870 ~ 1460Ω in 12 elderly patients. (2) 3 cases of elderly patients over 85 years of age after 1 week of active upper limbs lead to pacemaker pouch hemorrhage subcutaneous hematoma, found that local oppression and upper limb brachial, are self-absorbed and recovered. (3) 4 cases of intraoperative malignant arrhythmia. Conclusion Elderly patients due to physiological aging changes in the placement of permanent cardiac pacemaker process and postoperative complications prone to surgery, clinical treatment should be taken seriously.