Rehabilitation experience of intraoperative temporary epicardial pacing lead implantation after cardiopulmonary bypass_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

古丽丹 ,  武忠 , 屈模英 , 贺玥 , 黄丹

四川大学华西医院心脏综合病房（成都 610000）;

Corresponding author：

武忠, Email: wuzhong71@163.com

Keywords：

心外膜临时起搏导线; 临时起搏器应用; 体外循环; 术后管理; 康复

DOI：

10.7507/1007-4848.201606013

Video：

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目的探讨心脏外科体外循环术后留置心外膜临时起搏导线的康复经验。方法选取 2015 年 9 月至 2016 年 4 月 69 例体外循环术后留置心外膜临时起搏导线患者，其中男 26 例、女 43 例，平均年龄（50.2±11.5）岁。予术前及术后干预措施、出院指导和随访，评价康复效果。结果患者术后平均住院时间（9.8±2.6）d，69 例患者均顺利出院，其中 57 例患者顺利拔除心外膜临时起搏器导线，1 例患者因Ⅲ度房室传导阻滞继续留置临时起搏器电极，11 例患者残留临时起搏导线出院，出院后两周随访发现 2 例患者的临时起搏导线体内残端露出体表。结论心外膜临时起搏电极是心脏外科术后常见的风险防范手段之一，掌握临时起搏器导线的管理及临时起搏器应用的相关知识，合理管理能有效地降低术后并发症的发生，可促进患者术后康复。做好患者宣教，避免因沟通不畅导致的医患纠纷发生。

Citation： 古丽丹, 武忠, 屈模英, 贺玥, 黄丹. Rehabilitation experience of intraoperative temporary epicardial pacing lead implantation after cardiopulmonary bypass. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(4): 321-323. doi: 10.7507/1007-4848.201606013 Copy

1.	马发钰. 临时起搏器在外科手术中应用的临床研究. 四川医学, 2009, 10(10): 1613-1614.
2.	Chauhan M, Prentice E, Zidan M, et al. Necessity of temporary epicardial pacing wires after surgery for congenital heart disease.Ann Th orac Surg, 2014, 97(6): 2148-2153.
3.	Alwaqfi NR, Ibrahim KS, Khader YS, et al. Predictors of temporary epicardial pacing wires use after valve surgery. J Cardiothorac Surg, 2014, 9: 33.
4.	邱志兵, 陈鑫, 徐明, 等. Ⅲb 型缺血性二尖瓣反流外科治疗方式的早期临床效果及中远期疗效比较. 中国胸心血管外科临床杂志, 2015, 22(9): 831-836.
5.	解萍, 汪国文, 叶枫林, 等. 心脏外科术后心外膜临时起搏器的应用与护理. 中华全科医学, 2011, 4(5): 820-821.
6.	刘学, 董兵, 刘晓隗, 等. 改良起搏导线留置方法在二尖瓣置换手术围术期的应用. 中国心脏起搏与心电生理杂志, 2012, 26(4): 313-314.
7.	杨树全. 临时起搏器植入 16 例体会及并发症处理. 中国实用医药杂志, 2012, 29(7): 41-42.
8.	曾敏, 王旭, 李守军, 等. 婴幼儿完全性房室通道矫治术后快速康复. 中国胸心血管外科临床杂志, 2010, 18(6): 459-461.
9.	Shaikhrezai K, Khorsandi M, Patronis M, et al. Is it safe to cutpacing wires flush with the skin instead of removing them? Interact Cardiovasc Thorac Surg, 2012, 15(6): 1047-1051.
10.	Mishra PK, Lengyel E, Lakshmanan S, et al. Temporary epicardial pacing wire removal: is it an innocuous procedure? Interact Cardiovasc Thorac Surg, 2010, 11(6): 854-855.
11.	Spellberg RD, Dobkin JE, Soleymani S. Intracardiac migration of operatively placed epicardial pacing leads. Ann Th orac Surg, 2012,93(5): 1713-1715.
12.	Elmouchi DA, Rosema S, Vanoosterhout SM, et al. Cardiac perforation and lead dislodgement after implantation of a mr-conditional pacing lead: a single-center experience. Pacing Clin Electrophysiol, 2014, 37(1): 4-10.
13.	张晓慎, 刘菁, 郭惠明, 等. 全胸腔镜心脏手术术中放置心外膜临时心脏起搏导线的改良方法. 中国胸心血管外科临床杂志, 2015, 22(11): 1036-1038.

1. 马发钰. 临时起搏器在外科手术中应用的临床研究. 四川医学, 2009, 10(10): 1613-1614.
2. Chauhan M, Prentice E, Zidan M, et al. Necessity of temporary epicardial pacing wires after surgery for congenital heart disease.Ann Th orac Surg, 2014, 97(6): 2148-2153.
3. Alwaqfi NR, Ibrahim KS, Khader YS, et al. Predictors of temporary epicardial pacing wires use after valve surgery. J Cardiothorac Surg, 2014, 9: 33.
4. 邱志兵, 陈鑫, 徐明, 等. Ⅲb 型缺血性二尖瓣反流外科治疗方式的早期临床效果及中远期疗效比较. 中国胸心血管外科临床杂志, 2015, 22(9): 831-836.
5. 解萍, 汪国文, 叶枫林, 等. 心脏外科术后心外膜临时起搏器的应用与护理. 中华全科医学, 2011, 4(5): 820-821.
6. 刘学, 董兵, 刘晓隗, 等. 改良起搏导线留置方法在二尖瓣置换手术围术期的应用. 中国心脏起搏与心电生理杂志, 2012, 26(4): 313-314.
7. 杨树全. 临时起搏器植入 16 例体会及并发症处理. 中国实用医药杂志, 2012, 29(7): 41-42.
8. 曾敏, 王旭, 李守军, 等. 婴幼儿完全性房室通道矫治术后快速康复. 中国胸心血管外科临床杂志, 2010, 18(6): 459-461.
9. Shaikhrezai K, Khorsandi M, Patronis M, et al. Is it safe to cutpacing wires flush with the skin instead of removing them? Interact Cardiovasc Thorac Surg, 2012, 15(6): 1047-1051.
10. Mishra PK, Lengyel E, Lakshmanan S, et al. Temporary epicardial pacing wire removal: is it an innocuous procedure? Interact Cardiovasc Thorac Surg, 2010, 11(6): 854-855.
11. Spellberg RD, Dobkin JE, Soleymani S. Intracardiac migration of operatively placed epicardial pacing leads. Ann Th orac Surg, 2012,93(5): 1713-1715.
12. Elmouchi DA, Rosema S, Vanoosterhout SM, et al. Cardiac perforation and lead dislodgement after implantation of a mr-conditional pacing lead: a single-center experience. Pacing Clin Electrophysiol, 2014, 37(1): 4-10.
13. 张晓慎, 刘菁, 郭惠明, 等. 全胸腔镜心脏手术术中放置心外膜临时心脏起搏导线的改良方法. 中国胸心血管外科临床杂志, 2015, 22(11): 1036-1038.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Rehabilitation experience of intraoperative temporary epicardial pacing lead implantation after cardiopulmonary bypass

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