Bai Yang, Duan Jialin, Wang Lin, Bai Rong, Lin Li
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China.
Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China.
Exp Ther Med. 2017 Jun;13(6):2876-2882. doi: 10.3892/etm.2017.4366. Epub 2017 Apr 20.
A total number of 339 patients who received a pacemaker implantation between June 2012 and June 2014 at Tongji Hospital of Tongji Medical College (Wuhan, China) were investigated in the present study. The aims of the present study were to explore the risk factors of pocket hematoma following pacemaker implantation, and to analyze the effect of anti-allergy treatment on pocket-related complications following pacemaker implantation. Predictors of hematoma occurrence were determined and analyzed via a Chi-square test. Patients suffering from pocket hematoma, which were indicated to be partially caused by an allergic reaction to the pacemaker component, were distinguished by routine blood parameters. Furthermore, the pacemaker component was distinguished by histopathological examinations in one patient. Promethazine (25 mg/day) was used to treat allergic patients. The results demonstrated that in patients with a history of allergies, the rate of pocket hematoma was significantly higher when compared with patients without a history of allergies (22.00 vs. 7.61%; P=0.027). A significantly increased incidence of hematoma was indicated in patients with a lower body mass index when compared with patients of normal weight (15.79 vs. 7.38%; P=0.042). Furthermore, implantation of larger-sized devices, such as an implantable cardioverter-defibrillator and cardiac resynchronization therapy, were significantly predictive of hematoma development (29.63 vs. 8.01%; P=0.015). Patients with diabetes were also identified to exhibit a significantly high incidence of hematoma (22.22 vs. 8.25%; P=0.023). Promethazine administration significantly decreased the incidence of re-operating (P=0.017) and the duration of hospital stay (P=0.038) in patients whose pocket hematoma was caused by an allergy. In conclusion, promethazine may be a beneficial agent to treat pocket hematoma caused by allergic reactions following pacemaker surgery.
本研究调查了2012年6月至2014年6月期间在华中科技大学同济医学院附属同济医院（中国武汉）接受起搏器植入的339例患者。本研究的目的是探讨起搏器植入后囊袋血肿的危险因素，并分析抗过敏治疗对起搏器植入后囊袋相关并发症的影响。通过卡方检验确定并分析血肿发生的预测因素。通过常规血液参数区分部分由对起搏器组件过敏反应引起的囊袋血肿患者。此外，对1例患者的起搏器组件进行了组织病理学检查。使用异丙嗪（25mg/天）治疗过敏患者。结果表明，有过敏史的患者囊袋血肿发生率显著高于无过敏史的患者（22.00%对7.61%；P=0.027）。与正常体重患者相比，体重指数较低的患者血肿发生率显著增加（15.79%对7.38%；P=0.042）。此外，植入较大尺寸的设备，如植入式心脏复律除颤器和心脏再同步治疗，显著预测血肿的发生（29.63%对8.01%；P=0.015）。糖尿病患者的血肿发生率也显著较高（22.22%对8.25%；P=0.023）。在囊袋血肿由过敏引起的患者中，使用异丙嗪显著降低了再次手术的发生率（P=0.017）和住院时间（P=0.038）。总之，异丙嗪可能是治疗起搏器手术后过敏反应引起的囊袋血肿的有益药物。
