摘要
目的:探讨感染性心内膜炎(IE)的诊断、手术指征、手术时机及手术方式的选择,观察手术效果,总结临床治疗经验。方法:回顾性分析我院2001-01至2011-06接受手术治疗的232例IE患者资料。所有患者均经外科手术清除感染病灶,纠治瓣膜病变及心脏畸形。结果:术前血培养210例,其中阳性83例(阳性率39.5%);切除的组织培养197例,阳性108例(阳性率54.8%)。超声心电图发现有赘生物168例(72.4%)。术后并发症主要有低心排综合征18例,急性肾功能不全19例,肝功能损伤8例,上消化道出血5例,Ⅲ度房室传导阻滞4例,术后广泛渗血延迟关胸1例。术后早期死亡7例,死亡率3.0%。经积极治疗,225例痊愈出院。结论:IE是循环系统严重的感染性疾病,血培养和超声心动图检查具重要的诊断价值;适时而完善的外科手术治疗至关重要;术后继续抗感染维持治疗和心功能维护治疗是疗效的保证。
Objective ：To summarize our experience of diagnosis, surgical indication, timing and choice of approach for treating infective endocarditis （IE） for better clinical practice. Methods：We retrospectively studied 232 IE patients who were surgically treated in our hospital from January 2001 to June 2011. All patients received surgical removal of infected lesions, correction of valvular lesions and heart defects. Results：There were 210 patients received preoperative blood culture and the positive rate was 39.5% （83/210）, 197 pa- tients received tissue culture for surgically removed lesions and the positive rate was 54. 8% （108/197）. Ultrasound echocardio- graphy found vegetation in 72.4% （168/232） of patients. The major postoperative complications included low cardiac output syn- drome in 18 cases, acute renal failure in 19 eases,liver function injury in 8 cases, upper gastrointestinal bleeding in 5 eases, 11I ~ atrioventrieular block in 4 cases, after extensive infiltration blood delayed sternal closure in 1 case. The early postoperative mortality was 3.0% （7/232）. There were 225 patients cured and discharged. Conelusion：IE is a serious infectious diseases, preoperative blood culture and eehocardiography are valuable for IE diagno- sis. It is important to complete surgery in proper timing. Postoperative anti-inflammatory therapy and maintenance of cardiac func- tion must be guaranteed for treating IE patients.
出处
《中国循环杂志》
CSCD
北大核心
2012年第5期376-378,共3页
Chinese Circulation Journal
