负压伤口疗法在非复杂性心脏起搏器囊袋感染中的临床应用

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目的:探讨负压伤口疗法(NPWT)用于治疗非复杂性心脏起搏器囊袋感染的可行性。方法:2013年1月—2020年3月,北京大学第一医院心内科收治非复杂性心脏起搏器囊袋感染患者35例,行回顾性队列研究,其中男21例、女14例,年龄69(44,72)岁。在创面彻底清创联合持续NPWT(负压值约-n 16.67 kPa)的基础上,将起搏脉冲发生器埋植于胸大肌、胸小肌之间,原囊袋内放置引流管,关闭创面后再次同前行持续NPWT 5~7 d。起搏器重置术后观察10~12 d伤口愈合情况;术后随访6~42个月,观察有无感染复发。n 结果:起搏器重置术后10~12 d,35例患者皮肤伤口均愈合良好,拆除伤口缝线。术后随访6~42个月,31例患者起搏器囊袋感染消退,伤口愈合良好;4例患者在术后因再次感染,移除全套起搏系统。结论:对非复杂性心脏起搏器囊袋感染患者,在彻底清创的基础上,NPWT是一种可选的治疗方法。“,”Objective:To investigate the feasibility of negative-pressure wound therapy (NPWT) in the treatment of uncomplicated cardiac pacemaker pocket infection.Methods:From January 2013 to March 2020, 35 patients with uncomplicated cardiac pacemaker pocket infection were admitted to the Department of Cardiology of Peking University First Hospital, including 21 males and 14 females aged 69 (44, 72) years. The historical cohort study was conducted. After a complete debridement followed by continuous NPWT (with negative pressure of -n 16.67 kPa), the pacemaker was inserted into the new pocket between the musculus pectoralis major and pectoralis minor. Pressure drainage tube was put into the old pocket. NPWT with the same mode was used again for 5 to 7 days after the wound was closed. The wound healing was observed for 10 to 12 days after the operation of pacemaker replacement, and the recurrence of infection was observed during 6 to 42 months follow-up after operation.n Results:Ten to twelve days after the operation of pacemaker replacement, 35 patients had good wound healing, and sutures were removed. After 6 to 42 months follow-up after operation, thirty-one patients were cured with no recurrence of infection and well-healed wound; four patients who had recurrent infection received whole system removal after the operation.Conclusions:On the premise of complete debridement, NPWT is an alternative treatment for patients with uncomplicated cardiac pacemaker pocket infection.
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