目的 分析心脏起搏器置入患者术后感染的危险因素。方法 选择接受永久起搏器置入术患者512例,根据患者术后是否发生感染将其分为感染组和未感染组。对比分析两组患者的临床特征。起搏器置入患者术后感染为因变量,单因素分析中多个有显著差异的因素作为自变量,借助Logistic回归非条件模型进行多因素分析。结果 512例中,总共有25例在起搏器术后发生感染,感染率为4.50%;单因素分析结果显示,合并糖尿病、手术次数过多、手术时间过长、血肿、切口脂肪液化等因素均有统计学差异;多因素Logistic结果显示,起搏器患者术后感染的发生和多个变量有相应关系,其中主要与合并糖尿病(OR为3.56,95%CI:6.26~23.01)、手术次数过多(OR为3.07,95%CI:3.12~38.70)、手术时间过长(OR为2.96,95%CI:1.67~24.65)、血肿(OR为2.76,95%CI:1.31~18.90)、切口脂肪液化(OR为2.36,95%CI:1.31~3.65)有关。结论 起搏器置入术患者手术时间过长、合并糖尿病、血肿等均是引发起搏器术后感染的主要因素,术后按时复查及定期随访是提高其生活质量的必要手段。

Objective To analyze risk factors for infections and nursing intervention in patients after implantation of heart pacemakers.Methods A total of 512 patients who had undergone heart pacemaker implantation between February 2014 and September 2016 were recruited in this study. These patients were divided into the intervention group (infection) and the sham group (non infection) according to the occurrence of infections. During the follow-up study, a series of clinical symptoms were recorded, and the causative factors were identified and analyzed using single logistic regression analysis of factors and multiple logistic regression analysis of factors.Results Among the 512 patients, 25 cases (4.50%) suffered from infections. Single factor analysis showed that the incidence of diabetes, too frequent operations, longer hospital stay, hematoma, and fat liquefaction of incision was significantly different. Multiple factors analysis showed that these were independent risk factors. Infections were mainly associated with diabetes (OR=3.56, 95%CI: 6.26-23.01), too frequent operations (OR=3.07, 95%CI:3.12-38.70), long durations of surgery (OR=2.96, 95%CI:1.67-24.65), hematoma (OR=2.76, 95%CI:1.31-18.90), and incision fat liquefaction (OR 2.36, 95%CI:1.31-3.65).Conclusions The incidence of postoperative infections in patients with pacemakers is relatively high, which can be significantly controlled after effective management. Longer durations of surgery, diabetes and hematoma are main factors for infections. Timely re-examination and regular follow-up are essential to the life quality of patients.