感染性心内膜炎外科治疗36例(1)
 |
| 第1页 |
参见附件(922KB，1页)。
【摘要】目的:总结感染性心内膜炎的外科治疗效果，探讨其临床治疗策略。方法:2002年3月至2010年10月，外科手术治疗36例感染性心内膜炎病人。其中男21例，女15例；年龄21～53岁，平均(38.6±13.6)岁。合并原有风湿性心脏疾病22例，先天性心脏病14例。手术均在全身麻醉低温体外循环下进行，风心病人中行二尖瓣置换术(MVR)8例，二尖瓣、主动脉瓣双瓣置换(MVR+AVR)14例；先天性心脏病病人除予以动脉导管未闭(PDA)缝合，房、室间隔缺损(A,VSD)修补外，同期行二尖瓣置换4例，二尖瓣成形(MVP)3例。结果:本组术后早期死亡1例，术前心功能IV级，全身状况极差，感染难以控制并伴有消瘦及恶病质，术后死于严重低心排综合症及呼吸功能衰竭。术后随访18例，随访时间6个月～48个月，随访期内无复发，心功能恢复至I级9例，II级5例，III级4例。结论:感染性心内膜炎早期诊断、正确选择手术时机、术中彻底清除病灶、合理矫治原有病变及良好的围手术期处理是提高疗效的关键。
【关键词】感染性心内膜炎;心脏外科手术
【中图分类号】R654.2【文献标识码】B【文章编号】1008-6455(2011)04-0106-02
Surgical treatment of infective endocarditis in 36 patients*
LiJie1 Wang Qiang2 Zhou Qing2 et al.
【Abstract】Objective:To summarize the surgical treatment of infective endocarditis results of the clinical treatment strategy. Methods：From March 2002 to October 2010, 36 patients of IE underwent surgical treatment. There were 21 males and 15 female patients. The age ranged from 21 to 53 years old with a mean of (38.6±13.6) years old. There were 22 patients with rheumatic heart disease, 14 patients with congenital heart disease. Operations were carried out under general anesthesia, cardiopulmonary bypass, 8 rheumatic heart patients with mitral valve replacement(MVR), 14 with mitral valve, aortic valve replacement(MVR+AVR); congenital heart disease with 4 mitral valve replacement, 3 mitral valve plasty(MVP) ,in addition to closure of patent ductus arteriosus(PDA), atrial, ventricular septal defect repair(A,VSD). Results：One patient (2.7%, 1/36) died in hosptial due to severe low cardiac output syndrome and respiratory function failure.This patient was preoperative with grade IV cardiac function, poor general condition, difficult to control infection and cachexia associated with weight loss. 18 patients were followed up for 6 months to 48 months, no recurrence during follow-up, 9 cardiac function recovered to I, 5 recovered to II, 4 recovered to III. Conclusion：The early diagnosis of infective endocarditis, the right choice surgical time, intraoperative and complete removal of disease, a reasonable correction of the original lesion and good perioperative management is the key of improve the efficacy.
【Key words】cardiac surgery; infective endocarditis ......
您现在查看是摘要介绍页，详见PDF附件(922KB，1页)。