【摘要】　目的　 探讨起搏器植入术后并发局部慢性溃疡伴感染的综合治疗方法。　方法　 2005年1月-2010年5月，收治4例心脏起搏器植入术后并发局部慢性溃疡伴感染的患者。男3例，女1例；年龄3~79岁。心脏起搏器植入术后囊袋感染致皮肤破溃伴慢性溃疡2例，起搏器植入后局部张力过高所致局部慢性溃疡2例，其中2例患有2型糖尿病。所有患者均经过长期严格换药保守治疗3个月以上。手术彻底切除感染创面及相关包囊并尽可能剪除部分导丝，甚至更换导丝，根据情况原位或异位植入起搏器，并放置橡皮引流条，应用敏感抗生素5~7 d防治感染。术后2周拆线，主要观察患者切口对合情况，是否存在红肿、硬结、血肿、积液或化脓情况。　结果　 4例患者术后均Ⅰ期愈合；4例均获随访，随访时间7~11个月，平均9个月。原创面愈合好，无感染及溃疡发生。　结论　 通过外科手术综合治疗难治性心脏起搏器植入术后并发症，能取得满意疗效。
【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.

Citation： WU Junliang,Nicolas Crook,CEN Ying. Department of Burn and Plastic Surgery,West China Hospital,Sichuan University,Chengdu,Sichuan,P. R. China. Comprehensive Treatment for Intractable Ulcers with Infection after Pacemaker Implantation. West China Medical Journal, 2011, 26(10): 1452-1454. doi: Copy