摘要
目的探讨自体瓣膜感染性心内膜炎行瓣膜置换治疗术前抗生素应用的临床疗效。方法回顾性分析2010年3月-2012年9月于我院接受瓣膜置换治疗的46例自体瓣膜感染性心内膜炎患者的临床资料，按术前是否应用足程（4～6周）抗生素将其分为足程抗生素（FRA）组与非足程抗生素（NFRA）组，对其心功能分级、左心室射血分数、术后并发症的发生率和死亡率进行统计学分析。结果①术前两组患者的心功能分级、平均左心室射血分数及瓣膜功能障碍程度进行统计学分析，差异无显著性（P〉0．05）。②术后两组患者的心功能分级及平均左心室射血分数进行统计学分析，差异有显著性（P〈0．05），提示FRA组术后心功能恢复优于NFRA组。③两组患者住院期间无死亡病例，术后随访6个月。FRA组并发症发生率18％，NFRA组并发症发生率29．2％，两组比较，差异有统计学意义（P〈0．05），可认为FRA组并发症发生率低于NFRA组。④随访期间FRA组死亡2例（9．1％），NFRA组死亡3例（12．5％），两组比较差异有统计学意义（P〈0．05），提示FRA组死亡率低于NFRA组。结论自体瓣膜感染性心内膜炎的外科治疗中，围手术期联合抗生素治疗是有效的治疗方案，其中术前应用抗生素疗程4～6周能够取得更好的临床疗效。
Objective To observe clinical result of antibiotic in Peri-operative period of nature valve endocarditis patients accepted valve replacement surgery. Methods 46 patients of nature valve endocarditis accepted the valve replace- ment treatment were divided into full range of antibiotics group and does not meet full range of antibiotics group. The clinical data were analyzed. Results The NYHA functional class, mean left ventricular ejection fraction and valvular dys- function before operation of the two groups were not significantly different （P〉0. 05）. The NYHA functional class and mean left ventricular ejection fraction after operation of f the two groups were significantly different（P〈0.05）. The inci- dence of complications of the two groups was different （P〈0.05）. Conclusion The surgical treatment of the body valve infective endocarditis, perioperative antibiotic therapy is an effective treatment program. Preoperative antibiotic treatment 4 to 6 weeks can achieve better clinical efficacy.
出处
《西部医学》
2014年第3期314-316,319,共4页
Medical Journal of West China
关键词
感染性心内膜炎
外科治疗
抗生素
Infective endocarditis
Surgical treatment
Antibiotics
