成人感染性心内膜炎的外科治疗(附38例报告)  

Surgical treatmemt of infective endocarditis in adults(38 cases report)

作　　者：杨军民[1] 侯迈[1] 徐金星[1] 李令珂[1] 陈元恒[1] 张红超[1] 

机构地区：[1]空军总医院心血管外科,北京100142

出　　处：《北京医学》2012年第9期821-823,共3页Beijing Medical Journal

摘　　要：目的总结成人感染性心内膜炎的外科治疗经验。方法选择38例成人感染性心内膜炎患者,行受累瓣膜置换术及合并畸形处理,术前、术后抗感染治疗。结果行主动脉瓣置换术20例,二尖瓣置换术11例,双瓣置换术7例,同期行室间隔缺损修补术5例,房间隔缺损修补术2例,瓦氏窦瘤破裂修补术2例,动脉导管切断缝合1例,肺动脉瓣成形术1例。早期并发症4例,分别为开胸止血2例,胸骨哆开2例;远期主动脉瓣轻度瓣周漏1例。术后随访1～9年,无复发及死亡病例。结论早期明确诊断,及时的手术治疗,围手术期的正确处理可使感染性心内膜炎获得优良的治疗效果。Objective To summarize the experience in surgical treatment of infective endocarditis in adults. Methods Infected valves were replaced and associated cardiac abnormalities were corrected concomitantly in 38 patients with infective endocarditis. Antibiotics were given before and after operation. Results Aortic valve replacement was performed in 20 cases, mitral valve replacement in 11 cases, double valve replacement in 7 cases. The accompanying procedures include 5 cases of repair of ventricular septal defect, 2 cases of repair of atrial septal defect, 2 cases of repair of ruptured aneurysm of aortic sinus, 1 case of cutting and suture of patent ductus arteriousus, and 1 case of pulmonary valve repair. Early postoperative complications occurred in 4 cases, including 2 cases of re-exposure for bleeding and 2 cases of dehiscence of sternum. A late postoperative complication was mild aortic paravalvular leakage. No recurrence or death case was recorded during 1-9 years follow-up. Conclusions Satisfactory results could be obtained for infective endocarditis by early diagnosis, timely surgical operation and proper perioperative management.

关 键 词：感染性心内膜炎 外科治疗 瓣膜置换术 

分 类 号：R654.2[医药卫生—外科学]