摘要
目的 探讨感染性心内膜炎（IE）的临床特点、外科手术时机、手术和围术期治疗方法及疗效.方法 回顾性分析2000年1月至2013年12月我科手术治疗的38例IE患者的临床资料,其中行主动脉瓣置换术3例,二尖瓣置换术18例,二尖瓣成形术2例,三尖瓣置换术1例,三尖瓣成形术1例,室间隔缺损修补术7例,动脉导管结扎术1例,动脉导管切开缝合术1例,佛氏窦瘤破裂切除修补1例,BENTELL手术3例.所有患者均经外科手术清除感染病灶及赘生物,并纠治瓣膜病变和心脏畸形,术前术后应用大剂量敏感抗生素.结果 术后死亡1例,为主动脉瓣机械瓣膜置换术后严重低心排;1例二尖瓣置换术后2周复查心脏彩超发现轻中度瓣周漏;生存的34例患者术后随访心功能较前改善.结论 外科手术是治疗IE的有效手段,充分的术前准备、准确把握手术时机、足够疗程的抗感染治疗是提高手术成功率的关键.
Objective To investigate the clinical characteristics, surgical indications and surgical and pe- rioperational theatment method of infective endocarditis. Methods Surgical treatment of 38 cases with infective endocarditis between January 2000 and December 2013 was analyzed retrospectively, including 3 cases of aortic valve replacement, 18 cases of mitral valve replacement, 2 cases of mitral valvuloplasty, 1 case of tricuspid valvu- loplasty and 1 case of tricuspid valve replacement, 3 cases of BENTELL procedure. Thorough eliminate of infected tissue and necrotic issue, correction of cardiac abnormalities and valve replacement were done for all the patients. All were treated with high-dose of antibiotic before and after operation. Results 1 patient died due to severe low output after aortic valve replacement. 1 patient was found perivavular leakage 2 weeks after operation. 35 patients were follow-up with increased heart function. Conclusion It is effective to treat IE with surgery. The keys of treatment are effective preoperative preparation, surgery opportunity and antibiotic treatment.
出处
《中国心血管病研究》
CAS
2016年第7期623-626,共4页
Chinese Journal of Cardiovascular Research
关键词
感染性心内膜炎
外科治疗
回顾性分析
Infective endocarditis
Surgical treatment
Clinical analysis
