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題 名 | Tri-service General Hospital Clinical Experience with Permanent Cardiac Pacemakers=三軍總醫院裝置永久性心律調整器之臨床經驗 |
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作 者 | 魏崢; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 19:5 1986.11[民75.11] |
頁 次 | 頁391-397 |
分類號 | 416.262 |
關鍵詞 | 三軍總醫院; 永久性心律調整器; |
語 文 | 英文(English) |
中文摘要 | 本文就三軍總醫院在最近12年來裝置永久性心律調整器之經驗,做一追溯性之探討。在這12年中,我們共在191個病人身上裝置過206個永久性心律調整器,其中有15個是僅置換電池的手術。由於在這期間心律調整器本身之不斷更新與改進,我們在裝置的方法上也有改變。即使在現在,仍有許多有關心律調整器的選擇與裝置的方法是在爭議之中,意見也莫衷一是。依讓我們在三軍總醫院之資料,我們可以歸納出下述幾點意見:(1)在近年來,較多患有竇性綜合病徵之病人接受永久性心律調整器之手術,(2)經自劍突下裝置心外膜電極之心律調整器,因脈波發生器通常放在腹盤中,較易發生皮膚被磨爛之現象,(3)靜脈電極與心外膜電極發生刺激閥升高或電極移位之機會已經接近相等,(4)一且永久性心律調整器手術後發生傷口細菌感染,應儘速將脈波發生器取出行氣體消毒,再在數日後將它裝置在身體其他部位,與(5)我們建議在大部分之病人採用經由靜脈之方法裝置永久性心律調整器。 |
英文摘要 | This is a retrospective clinical study concerning the use of permanent cardiac pacemakers. In the past 12 yeaer, 206 permanent cardiac pacemakers have been implanted in 191 patients at Tri-Service General Hospital, with much improvement in result achieved during this evolutionary period. Policy has been changed; the experience has been accumulated. There remain some controversial points regarding the mode of pacing and the way of implantation. And the current trend of cardiac pacemaker is still changing. This study focuses on both earlier and more recent experiences. According to the data, (1) Sick sinus syndrome is becoming a more common indication for permanent cardiac pacemaker, (2) Epicardial placement of pacemaker with pulse generator in the abdominal wall is more vulnerable to skin erosion, (3) Transvenousand epicardial lead have simllar risk of threshold elevation or lead displacement, (4) During wound infection, immediate removal of pulse generator and replacement to another site is the treatment of choice, and (5) Transvenous implantation of a permanent cardiac pacemaker is preferred in most patients because of its simplicity, fewer complications, and no need for general anesthesia. |
本系統中英文摘要資訊取自各篇刊載內容。