阜外医院应用新型技术拔除心脏电极,可明显降低并发症

2018-06-13 佚名 中国循环杂志

随着心律植入装置的植入量日益增多,囊袋感染、电极导线破损以及植入静脉堵塞等并发症也不断增加。


随着心律植入装置的植入量日益增多,囊袋感染、电极导线破损以及植入静脉堵塞等并发症也不断增加。
 
经静脉拔除电极导线成为必要的选择。导线拔除的成功率部分是由拔除工具决定。
 
阜外学者尝试运用导线锁定钢丝(LLD)这种新型全程锁定钢丝系统拔除心律植入装置电极导线,初步结果显示该方法安全、有效,有利于导线完全拔除。
 
研究者为6例患者使用LLD拔除电极导线,共拔除导线13根(1根废弃电极导线和12根有功能电极导线),其中LLD成功放置在11根电极导线的顶端进行全程锁定,2根未全程锁定。12根电极导线完全拔除,1根部分拔除,无严重并发症发生。
 
本研究纳入的患者均为电极导线长期植入后的患者。所有电极导线被完全和部分拔除的患者,经术后2周的抗生素治疗,感染症状得以完全控制。
 
相比传统的锁定钢丝,LLD的优势在于钢丝直径更细、在导线内腔移动度大、更易到达电极远端。

研究者强调,使用LLD时,应严格掌握导线拔除适应证和待拔除电极导线的特点。LLD锁定钢丝适用于经静脉拔除植入时间较长的起搏器或埋藏式心脏复律除颤器的电极导线,导线内腔直径应与LLD型号匹配,且拔除途径为上腔静脉。当导线近端堵塞或无法匹配导线内径时,应禁止使用。

原始出处:

董潇男,唐闽,冯天捷,等. 新型锁定钢丝拔除心律植入电极导线的初步临床应用. 中国循环杂志, 12: 1199. 

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    2019-04-03 丁鹏鹏
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    2018-06-13 1e0f8808m18(暂无匿称)

    好文章.学习了.

    0

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    2018-06-13 phoebeyan520

    谢谢分享.学习了

    0

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