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回顾分析行永久性心脏起搏器植入术患者487例,术后并发感染13例,其术后并发感染原因包括:患者伴有基础疾病;手术因素,如手术持续时间长、装置囊袋不合适、囊袋血肿;术前备皮不到位,术后伤口敷料有渗液、渗血未及时换药。预防对策:基础疾病控制,加强术前宣教;认真贯彻手术无菌操作原则,增强医护配合能力;术前规范备皮,术后密切观察切口情况,发现异常及时处理,并做好出院后随访。本组11例患者积极换药、加强抗感染等保守治疗,有10例抗感染成功,随访期间(术后2~5年)未再发囊袋感染,1例感染反复发作予持续换药;1例将原起搏器消毒后重新置入治愈;1例去除原起搏器及电极导线,对侧置植入新起搏器后痊愈。
Retrospective analysis of 487 patients with permanent pacemaker implantation, postoperative infection in 13 cases, postoperative complications include: patients with underlying disease; surgical factors, such as surgery for a long time, the device does not bag Appropriate, cyst hematoma; preoperative skin preparation is not in place, postoperative wound dressing exudate, bleeding is not timely dressing. Preventive measures: control of basic diseases, strengthen preoperative education; conscientiously implement the principle of sterile operation of surgery to enhance the health care with the ability; preoperative specification skin preparation, close observation of the incision after surgery, abnormal and timely treatment, and well discharged after follow-up. The group of 11 patients actively dressing, to strengthen the anti-infective and other conservative treatment, 10 cases of successful anti-infection, during follow-up (2-5 years after surgery) did not recruit pocket infection, 1 case of recurrent infection to continuous dressing; One case of the original pacemaker sterilized before re-placed in the cure; 1 case of the original pacemaker and electrode leads removed, after implantation of new pacemaker healed.