摘要目的:探讨负压伤口疗法（NPWT）治疗非复杂性心脏起搏器囊袋感染的可行性。方法:2013年1月—2020年3月，北京大学第一医院心内科收治非复杂性心脏起搏器囊袋感染患者35例，行回顾性队列研究，其中男21例、女14例，年龄27~84岁。在创面彻底清创联合持续NPWT（负压值约-16.67 kPa）的基础上，将脉冲发生器埋植于胸大肌、胸小肌之间，原囊袋腔隙内放置引流管，关闭创面后再次同前行持续NPWT治疗5~7 d。对本组患者切除囊袋组织行苏木精-伊红染色观察；观察起搏器重植术后10~12 d伤口愈合情况；术后随访6~42个月，观察有无感染复发。结果:本组患者囊袋组织可见纤维囊壁，局部被覆复层上皮，较多慢性炎症细胞浸润，部分患者囊袋组织伴多核巨细胞反应。起搏器重植术后10~12 d，35例患者皮肤伤口均愈合良好，拆除伤口缝线。术后随访6~42个月，31例患者起搏器囊袋感染消退，伤口愈合良好；4例患者在术后因再次感染，移除全套起搏系统。结论:对非复杂性心脏起搏器囊袋感染患者，在彻底清创的基础上，NPWT是一种可选的治疗方法。

abstractsObjective:To investigate the feasibility of negative-pressure wound therapy (NPWT) in the treatment of uncomplicated cardiac pacemaker pocket infection.Methods:From January 2013 to March 2020, 35 patients with uncomplicated cardiac pacemaker pocket infection were admitted to the Department of Cardiology of Peking University First Hospital, including 21 males and 14 females, aged 27 to 84 years. The retrospective cohort study was conducted. After a complete debridement followed by continuous NPWT (with negative pressure of -16.67 kPa), the pulse-generator was inserted into the new pocket between the musculus pectoralis major and pectoralis minor. Pressure drainage tube was put into the old pocket space. NPWT with the same mode was used again for 5 to 7 days after the wound was closed. The removed pocket tissue of patients was observed with hematoxylin-eosin staining. The wound healing on 10 to 12 days after the operation of pacemaker replacement was observed, and the recurrence of infection was observed during 6 to 42 months follow-up after operation.Results:The fibrous sac wall was observed in pocket tissue of the patients, and the tissue was partially covered with stratified epithelium, with many chronic inflammatory cells infiltration. Multinucleated giant cell reaction was observed in the tissue of some patients. Ten to twelve days after the operation of pacemaker replacement, 35 patients had good wound healing, and sutures were removed. After 6 to 42 months follow-up after operation, 31 patients were cured with no recurrence of infection and the wounds were well-healed; 4 patients who had recurrent infection received whole system of pacemaker removal after the operation.Conclusions:On the premise of complete debridement, NPWT is an alternative treatment for patients with uncomplicated cardiac pacemaker pocket infection.