目的:系统评价心脏植入式电子设备(CIED)植入术后设备感染(DRI)的风险预测模型。方法:通过计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、CINAHL、中国生物医学文献数据库、中国知网、维普网、万方数据库中与CIED植入术后...目的:系统评价心脏植入式电子设备(CIED)植入术后设备感染(DRI)的风险预测模型。方法:通过计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、CINAHL、中国生物医学文献数据库、中国知网、维普网、万方数据库中与CIED植入术后DRI风险预测模型相关的文献,检索时间为从建库至2023年12月2日。由2名研究者独立筛选文献、提取资料并完成纳入文献的偏倚风险与适用性评价。结果:共纳入16项研究,模型总体适用性较好,但偏倚风险较高,ROC曲线的AUC为0.67~0.96。11项研究完成了内部验证,5项研究进行了外部验证。囊袋和(或)电极重置/装置升级、肾功能不全或肾功能衰竭、年龄、植入埋藏式心脏复律除颤器或心脏再同步化治疗、使用抗凝药是DRI的预测因子。结论:目前CIED植入术后DRI风险预测模型整体性能较好,适用性较好,但偏倚风险较高。需在数据来源、变量筛选、模型评价等方面提高研究质量,开展前瞻性队列研究,完善现有模型的外部验证,并积极研发适用于我国人群的预测模型。展开更多
The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis di...The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis difficult with traditional methods and in patients at high risk for surgical site infections(SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.展开更多
Background：The conventional venous access for cardiovascular implantable electronic device （CIED） is the subclavian vein,which is often accompanied by high complication rate.The aim of this study was to assess the ...Background：The conventional venous access for cardiovascular implantable electronic device （CIED） is the subclavian vein,which is often accompanied by high complication rate.The aim of this study was to assess the efficacy and safety of optimized axillary vein technique.Methods：A total of 247 patients undergoing CIED implantation were included and assigned to the axillary vein group or the subclavian vein group randomly.Success rate of puncture and complications in the perioperative period and follow-ups were recorded.Results：The overall success rate （95.7% vs.96.0%） and one-time success rate （68.4% vs.66.1%） of punctures were similar between the two groups.In the subclavian vein group,pneumothorax occurred in three patients.The subclavian gaps of three patients were too tight to allow operation of the electrode lead.In contrast,there were no puncture-associated complications in the axillary vein group.In the patient follow-ups,two patients in the subclavian vein group had subclavian crush syndrome and both of them received lead replacement.The incidence of complications during the perioperative period and follow-ups of the axillary vein group and the subclavian vein group was 1.6% （2/125） and 8.2% （10/122）,respectively （χ^2=5.813,P =0.016）.Conclusion：Optimized axillary vein technique may be superior to the conventional subclavian vein technique for CIED lead placement.展开更多
文摘目的:系统评价心脏植入式电子设备(CIED)植入术后设备感染(DRI)的风险预测模型。方法:通过计算机检索PubMed、Embase、Web of Science、Cochrane图书馆、CINAHL、中国生物医学文献数据库、中国知网、维普网、万方数据库中与CIED植入术后DRI风险预测模型相关的文献,检索时间为从建库至2023年12月2日。由2名研究者独立筛选文献、提取资料并完成纳入文献的偏倚风险与适用性评价。结果:共纳入16项研究,模型总体适用性较好,但偏倚风险较高,ROC曲线的AUC为0.67~0.96。11项研究完成了内部验证,5项研究进行了外部验证。囊袋和(或)电极重置/装置升级、肾功能不全或肾功能衰竭、年龄、植入埋藏式心脏复律除颤器或心脏再同步化治疗、使用抗凝药是DRI的预测因子。结论:目前CIED植入术后DRI风险预测模型整体性能较好,适用性较好,但偏倚风险较高。需在数据来源、变量筛选、模型评价等方面提高研究质量,开展前瞻性队列研究,完善现有模型的外部验证,并积极研发适用于我国人群的预测模型。
文摘The manuscript describes the efficacy of a new skin closure system(Zip Line?) for wound closure after pacemaker/implantable cardioverter defibrillator surgery. The system is particularly useful when wound healingis difficult with traditional methods and in patients at high risk for surgical site infections(SSIs). This skin closure option is easy and quick to apply and remove, and produces excellent cosmetic results. Although it is associated with a minimal expense upcharge, the benefits, including the potential for decrease in SSI, make it attractive and worth considering for skin closure in device patients, particularly those at increased risk of complications.
文摘Background：The conventional venous access for cardiovascular implantable electronic device （CIED） is the subclavian vein,which is often accompanied by high complication rate.The aim of this study was to assess the efficacy and safety of optimized axillary vein technique.Methods：A total of 247 patients undergoing CIED implantation were included and assigned to the axillary vein group or the subclavian vein group randomly.Success rate of puncture and complications in the perioperative period and follow-ups were recorded.Results：The overall success rate （95.7% vs.96.0%） and one-time success rate （68.4% vs.66.1%） of punctures were similar between the two groups.In the subclavian vein group,pneumothorax occurred in three patients.The subclavian gaps of three patients were too tight to allow operation of the electrode lead.In contrast,there were no puncture-associated complications in the axillary vein group.In the patient follow-ups,two patients in the subclavian vein group had subclavian crush syndrome and both of them received lead replacement.The incidence of complications during the perioperative period and follow-ups of the axillary vein group and the subclavian vein group was 1.6% （2/125） and 8.2% （10/122）,respectively （χ^2=5.813,P =0.016）.Conclusion：Optimized axillary vein technique may be superior to the conventional subclavian vein technique for CIED lead placement.
