10例感染性心内膜炎外科治疗经验分析

Clinic Analysis of 10 Cases of Infective Endocarditis

目的总结原发性感染性心内膜炎外科治疗的围术期和术中经验。方法对我院连续收治的10例符合Duke诊断标准的原发性感染性心内膜炎患者进行回顾性研究。结果男性7人,女性3人,男女比为2.3:1,年龄41.8±12.9岁,30天内病死率为20%。主要易患因素为风湿性心脏病,其次为先天性心脏病,主要致病菌为金黄色葡萄菌属和链球菌属,TTE赘生物检出率为100%,大小为20.1±9.4mm,主要受累瓣膜为二尖瓣和主动脉瓣。结论感染性心内膜炎仍是高病死率疾病,心脏彩超可以提高其诊断率,赘生物栓塞患者早期手术有利于提高治愈率,术前左前分支传导阻滞术后易发恶性心律失常。

Objective To summarize surgical treatment experience of active infective endocarditis.Methods A retrospective study was applied in 10 consecutive patients who fulfilled the Duke criteria for the diagnosis of infective endocarditis at our hospital.Results The 10 patients had a male to female ratio of 2.3∶1,mean age of 41.8±12.9 years.The morality rate was 20% in 30 days.The most risk factors were rheumatic heart disease and congenital heart disease.The etiology were Staphylococcus aureus and Streptococcus.Vegetations were easily detected by TTE,with length 20.1±9.4mm,and the most affected vatves were mitral valves and aortic valves.Conclusion Infective endocarditis still remains a lethal disease.With the utilization of TTE,the diagnosis rate of IE could be improved.In the case of IE embolic event,earlier operation has a better prognosis.Left bundle branch block was associated with post-operative vicious cardiac arrhythmia.