感染性心内膜炎的外科治疗  

Surgical treatment of infective endocarditis

作　　者：臧蔚[1] 邵冲[1] 谢永明[1] 朱家麟[1] 彭勇[1] 戴春雷[1] 

机构地区：[1]苏州市立医院本部胸心外科,江苏苏州215002

出　　处：《岭南现代临床外科》2011年第2期143-145,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨感染性心内膜炎(IE)的外科手术治疗效果及围术期处理原则。方法回顾性分析2001年3月～2010年10月接受感染性心内膜炎手术治疗患者15例的临床资料。术前经超声心电图检查证实心内赘生物形成者15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。结果术后早期死亡1例(6.7%),术后随访时间3～48月,随访14例(93.3%),均无心内膜炎复发,心功能恢复I级12例,Ⅱ级2例。结论外科手术治疗感染性心内膜炎是一种有效的治疗方法。正确掌握手术时机,彻底清除感染病灶,恢复瓣膜功能以及围手术期应用有效抗生素是提高感染性心内膜炎治愈率的生要措施。Objective To investigating surgery principle and perioperative management of infectious endocarditis（IE）.Methods Clinical data of 15 IE cases,treated surgically from March 2001 to October 2010 were retrospectively analyzed.All cases were complicated with primary cardiac diseases.9 males,5 females,aging from 23 to 56 years.Vegetations were in all cases founded by echoeardiography.For all patients,infective tissues and vegetations were debrided radically,intracardiac malformation was corrected,and valve replacement or plasty was performed.High dose of sensitive antibiotics wereused all through the treatment in all IE patients.Results The early-death occurred in 1 cases（6.7%）.Follow-up visit lasted for 3～48 month in 14patients（93.3%）with no-recurrence,Post-operative cardiac function（NYHA）evaluation displayed Class I in 12 cases,and Class 11 in 2 cases.Conclusion This study indicated that surgery is an effective treatment for infective endocarditis,which can reduce the mortality.Optimal timing of surgery,radical debridement infected tissue,recovery of valve function and utilizing antibiotics in peri-operative stage are the key points to improve the surgical treatment in infected endocarditis.

关 键 词：感染性心内膜炎 外科治疗 

分 类 号：R654.2[医药卫生—外科学]