感染性心内膜炎患者的临床特点与外科治疗分析  

Analysis on clinical characteristics of patients with infective endocarditis and the surgical procedures

作　　者：徐灿[1] 潘俊[1] 周庆[1] 王东进[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心胸外科,南京市210008

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第3期35-38,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：江苏省医学重点学科项目;南京心血管病临床医学中心项目

摘　　要：目的探讨感染性心内膜炎(IE)患者外科治疗的疗效。方法对2008年1月至2013年12月本科室收治的94例行外科手术治疗的IE患者临床资料进行回顾性分析,分析患者的一般资料、血培养病原学种类、超声心动图改变及外科治疗效果和预后。结果 94例感染性心内膜炎患者术前血培养阳性43例,阳性率为45.74%;90例患者治愈,治愈率为95.74%;手术后30 d内2例患者死亡,其中1例死于心力衰竭,1例死于多器官功能衰竭,病死率为2.13%(2/94)。平均随访25个月,患者生存良好,活动耐力显著增加,未发生感染性心内膜炎、出血或血栓并发症。结论 IE患者的早期临床症状和体征缺乏特异性,诊断在一定程度上依赖于首诊医生的经验及警惕性,应结合血培养结果和超声心动图的检查确诊。瓣膜赘生物形成即有手术指征,防止其脱落带来更严重后果,内科治疗保守无效应行急诊外科手术治疗。Objective To investigate the infective endocarditis （IE） in patients with surgical treatment. Methods Total of 94 cases of patients with infective endocarditis, who received the surgical procedures in our hospital from January 2008 to December 2013 were analyzed, retrospectively, then the general data, the species of pathogens from blood cultured, echocardiographic changes, effects of surgical procedures and prognosis of the subjects were detected, respectively. Results Among the 94 cases of infective endocarditis, 43 cases were with the blood cultured positive, with the positive rate of 45.74%; 90 cases were cured and improved, with the improved rate of 95.74%, and 2 cases died, including 1 case of death from heart failure and 1 case of death from multiple organ failure. The average follow-up time was 25 months, survival, activity endurance increased significantly, without the occurrence of infective endocarditi~, bleeding or thrombotic complications. Conclusions The early clinical signs and symptoms of IE is lack of specificity, diagnostic experience and vigilance dependent to a certain degree, the first doctor, combined with the results of blood cultures to confirm the diagnosis and echocardiography. Valve excrescence has surgical indications, and prevent its loss lead to more disastrous consequences, conservative medical treatment no effect underwent emergency surgery.

关 键 词：感染性心内膜炎 外科手术 临床特点 

分 类 号：R654.2[医药卫生—外科学]