【摘要】　目的　 探討起搏器植入術后并發局部慢性潰瘍伴感染的綜合治療方法。　方法　 2005年1月-2010年5月，收治4例心臟起搏器植入術后并發局部慢性潰瘍伴感染的患者。男3例，女1例；年齡3~79歲。心臟起搏器植入術后囊袋感染致皮膚破潰伴慢性潰瘍2例，起搏器植入后局部張力過高所致局部慢性潰瘍2例，其中2例患有2型糖尿病。所有患者均經過長期嚴格換藥保守治療3個月以上。手術徹底切除感染創面及相關包囊并盡可能剪除部分導絲，甚至更換導絲，根據情況原位或異位植入起搏器，并放置橡皮引流條，應用敏感抗生素5~7 d防治感染。術后2周拆線，主要觀察患者切口對合情況，是否存在紅腫、硬結、血腫、積液或化膿情況。　結果　 4例患者術后均Ⅰ期愈合；4例均獲隨訪，隨訪時間7~11個月，平均9個月。原創面愈合好，無感染及潰瘍發生。　結論　 通過外科手術綜合治療難治性心臟起搏器植入術后并發癥，能取得滿意療效。
【Abstract】　Objective　 To explore comprehensive treatment options for local chronic ulcer with infection after the pacemaker implantation.　Methods　 From January 2005 to May 2010, four patients (3 males and 1 female; 3-79 years old) with intractable ulcer with infection after pacemaker implantation were admitted. Pacemaker pocket infection induced chronic ulcer was in two, and tension induced chronic ulcers were in two. Two of the four patients were type II diabetes. All of the four patients underwent strict conservative treatment at least for 3 months prior to surgical treatment. Surgical treatment involved complete excision of infected tissue surrounding the pacemaker pocket and removal of all unnecessary lengths of pacemaker lead, even complete replacement of the original lead. Depending on the specific situation, pacemakers were either placed in their original position or a new position with a latex drainage strip. Patients then received a course of antibiotic treatment ranging from 5 to 7 days.　Results　 All of the four patients achieved healing by first intention, and were followed up for 7-11 months, with an average of 9 months follow up. All patients achieved the satisfactory results.　Conclusion　 A comprehensive treatment is effective on local chronic ulcer with infection after the pacemaker implantation.

引用本文： 伍俊良,Nicolas Crook,岑瑛. 心臟起搏器植入術后并發局部慢性潰瘍伴感染的綜合處理. 華西醫學, 2011, 26(10): 1452-1454. doi: 復制