感染性心内膜炎的外科治疗

Study on the surgical treatment of infective endocarditis

目的总结感染性心内膜炎(IE)的外科治疗经验。方法1994年4月至2007年6月,本院120例IE患者在接受内科抗感染治疗的同时,采取积极的外科手术治疗。结果围术期死亡1例(0.83%),远期IE复发死亡2例,其余患者经随访心功能均恢复至I～II级。结论外科手术治疗感染性心内膜炎是一种有效的治疗措施,降低了感染性心内膜炎的病死率。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关键。

Objective To review the experience of surgical treatment of infective endocarditis. Methods From April, 1994 to June, 2007, 120 patients with infective endocarditis receiving surgical intervention while utilizing effecitve antibiotics were reviewed. Results There was 1 patient dead in peri - operative stage. There were 2 late death due to recurrence of infective endocarditis; the other patients were followed up and all of their heart function were restored to NYHA class Ⅰ or Ⅱ. Conclusions Surgical treatment is effective for infective endocarditis, which can reduce the mortality. Optimal timing of surgery, radical debridement infectied tissue, recovery of valve ruction and utilizing antibiotics in peri - operative stage are the key points to improve the surgical treatment in infected endocarditis.