心律植入装置右心感染性心内膜炎的临床特点  

Clinical characters of 16 cases of right-sided infective endocarditis related to pacemakers

作　　者：方勇[1] 李学斌[2] 刘刚[2] 王龙[2] 李鼎[2] 张萍[2] 郭继鸿[2] 朱天刚[2] 

机构地区：[1]武汉市第一医院心内科,湖北武汉430020 [2]北京大学人民医院心脏中心电生理室,北京100044

出　　处：《中国心脏起搏与心电生理杂志》2014年第3期209-211,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：首都临床特色应用研究项目(项目编号:Z121107001012016)

摘　　要：目的回顾性分析心律植入装置相关右心感染性心内膜炎的临床特征,为其早期诊断和及时治疗提供临床参考。方法对16例心律植入装置相关右心感染性心内膜炎患者的临床资料进行回顾性分析。结果 16例患者中男性13例,女性3例,年龄(59±18)岁,临床主要表现为发热15例(93.8%),血培养阳性12例(75.0%),其中表皮葡球菌4例(25.0%)为最常见病原菌。16例经胸超声检查均发现赘生物。9例在经静脉途径移除心律植入装置基础上给予抗感染治疗,7例在外科开胸直视手术下移除心律植入装置的基础上给予抗感染治疗,16例患者均痊愈出院。结论表皮葡萄球菌为最常见病原菌。完全移除感染装置是心律植入装置相关右心感染性心内膜炎治疗的基石。Objective To investigate the clinical features of fight-sided infective endocarditis related to pacemakers. Methods A retrospective analysis was undertaken in 16 patients diagnosed as fight-sided infective endocarditis related to pacemakers who had been admitted to hospital from January 2001 to May 2012. Results Sixteen patients include 13 males and 3 females,the mean age was （59±18）years. Fever occurred in 93.8% , A positive culture was obtained in 75. 0% ,Staphylococcus epidermidis was found in 25.0%. Transthoracic echocardiography demonstrated vegetations in all of patients. 9 patients were treated with combined management of transvenous removal and antibiotics ,7 patients with surgical removal during extracorporeal circulation combined with antibiotics. 16 patients were cured. Conclusion Staphylococcus epidermidis is the most common pathogen. Complete removal of pacemakers is the cornerstone of the treatment.

关 键 词：心血管病学 感染性心内膜炎 右心 心律植入装置 

分 类 号：R318.11[医药卫生—生物医学工程] R542.41[医药卫生—基础医学]