38例感染性心内膜炎的临床分析

Clinical analysis of 38 oases with infeotive endooarditis

目的总结感染性心内膜炎38例的诊断、手术时机和疗效。方法回顾分析2002年1月～2008年12月接受手术治疗的感染性心内膜炎38例，其中先天陛心脏病11例（28．9％），风湿性心脏病12例（31．6％），退行胜变6例（15．8％），无基础病变者9例（23．7％），所有病人经外科手术清除感染病灶，纠治瓣膜病变及心脏畸形，术前进行血培养和彩色超声心动图检查。结果外科手术治疗前，超声心动图发现心脏及大血管赘生物32例（84．2％），血培养阳性17例（44．7％）。手术后死亡2例（5．2％）。结论感染性心内膜炎早期诊断，适时手术和内、外科联合治疗是治疗成功的关键。

Objectives To summarize the diagnosis, operation time and curative effect of 38 cases with infective endocarditis. Methods 38 cases with infective endocarditis receiving operation between January 2002 and December 2008 were analyzed retrospectively. All patients were treated by operation, and color-Doppler echocardiography were carried out before operation. The principles of the operations were to remove the infection tissue, correct and cure the pathological changes of valve and cardiac anomalies.Results Among the 38 cases, 11 cases of them had congenital heart disease（28.9%）, 12 cases had rheumatic heart disease（31.6% ）, 6 cases had degenerate valvular disease（15.8%） and 9 cases had no structural pathological changes （23.7%）. Before surgical treatment, echocardiography found that 32 cases had vegetations on heart and great vessels （84.2%）, positive blood cultivations were found in 17 cases（rid.7%）. After operation, 2 cases （5.2%） died. Conclusions The key to treat infective endocarditis successfully depends on early diagnosis, operation at the right time, and combination of internal and surgical treatment.