活动期感染性心内膜炎的外科治疗:进展与挑战  

Surgical treatment for active infective endocarditis:progress and challenges

作　　者：刘鑫裴 苗齐[1] LIU XinPei;MIAO Qi(Department of Cardiac Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院&北京协和医学院,北京协和医院心外科,北京100730

出　　处：《中国科学：生命科学》2021年第8期970-978,共9页Scientia Sinica(Vitae)

摘　　要：感染性心内膜炎(infective endocarditis,IE)是古老而有挑战性的疾病,其病死率在百余年来居心脏瓣膜病死亡率之首.IE的治疗方法由最初的单纯抗感染治疗,向活动期抗感染+愈合期手术治疗转变,逐渐发展为今天的活动期手术治疗为主.但由于IE本身具有多系统受累、病情多变的特点,在复杂的IE病例中,如何做到早期诊断、把握恰当的手术指征和手术时机、准确评估手术风险仍为目前亟待讨论的问题.本文以IE的早期诊断、手术指征、手术时机和手术风险为线索,以近20年国内外代表性文献为基础,结合我院诊治经验,对相关问题的共识和争议进行述评,梳理出IE活动期手术的最新进展和仍面临的挑战,并强调临床实践中建立IE专病多学科团队的重要性.Infective endocarditis(IE)is a challenging disease.In the past century,it has the highest mortality among all kinds of valvular heart diseases.Treatment for IE has developed over time from anti-infective therapy only to today’s active surgery.However,due to its characteristics of multisystem involvement and changeable clinical symptoms,early diagnosis,indication and timing of surgery,and evaluation of surgical risk remain urgent issues at present.By reviewing representative literature in the past 20 years and combining them with our experience of surgical treatment for IE,we summarize the latest progress and challenges faced by active surgery for IE,and emphasize the importance of establishing IE multidisciplinary team in clinical practice.

关 键 词：感染性心内膜炎 外科学 治疗 

分 类 号：R654.2[医药卫生—外科学]