摘要
目的总结感染性心内膜炎的早期诊断和外科治疗经验。方法回顾性分析1998年10月至2010年8月在广西医科大学第四附属医院接受感染性心内膜炎手术治疗的29例患者的临床资料，男19例，女10例；年龄14～54岁，平均35岁。术前血培养阳性9例（31％），超声心动图提示有心内赘生物25例（86％）。原有基础病变24例，其中先天性心脏病8例，风湿性心脏病11例，二尖瓣脱垂4例，主动脉瓣置换术后l例。全部病例均在中度低温体外循环下进行，急诊手术6例，择期手术23例。手术中彻底清除感染灶，其中二尖瓣置换术11例，主动脉瓣置换术9例，二尖瓣和主动脉瓣双瓣置换术6例，三尖瓣修复成形术5例，室间隔缺损修补2例，主动脉窦瘤修补1例，肺动脉瓣赘生物切除1例。结果术后早期死亡1例，其余28例随访8个月～6年，无远期死亡及复发病例。结论早期诊断，掌握适当的手术时机，加强围术期处理，感染性心内膜炎可取得较好的治疗效果。
Objective To summarize the experience of early diagnosis and surgical treatment of infective endocarditis. Methods Twenty-nine patients with infective endoeardifis were collected from October 1998 to August 2010, including 19 males and 10 females. The patients＇ ages were 14- 54 year old, with an average of 35 years old. The clinical data of the patients were reviewed. The preoperative blood culture was positive in 9 ca- ses（31 % ）, echocardiogram showed ecptoma in 25 cases（86% ）. The original pathological changes in 24 cases, including 8 congenital heart diseases, 11 rheumatic heart diseases, 4 mitral prolapse and 1 aortic valve replacement. All the operations were implemented under by-pass at moderate or low temperature. Among them, 6 cases received emergency operations, 23 cases received selective operation. During the operation, all the focus of infection was cleaned. The procedures included 11 cases of mitral valve re- placement, 9 cases of aortic valve replacement, 6 cases of mitral valve and aortic valve replacement, 5 cases of tricuspid repair, 2 cases of interventricular septal defect repair, 1 case of aneurysm of valsalva sinus repair and 1 case of pulmonary valve ecptoma resection. Results One case died after operation and the rest 28 cases were followed up for 8 months to 6 years, and no long-term death or relapse were found. Conclusions Good curative effects can be obtained through early diagnosis and proper timing of the operations and good peri-operative treatment.
出处
《中国实用医刊》
2013年第17期42-44,共3页
Chinese Journal of Practical Medicine
关键词
感染性心内膜炎
心脏外科
Infective endocartitis
Cardiac surgery
