先天性心脏病合并感染性心内膜炎24例外科疗效分析

Surgical treatment of 24 cases suffered from congenital heart disease with infective endocarditis

目的 分析先天性心脏病合并感染性心内膜炎的外科手术疗效.方法 24例先天性心脏病合并感染性心内膜炎患者均在体外循环下进行畸形矫正和赘生物清除.室间隔缺损（VSD）直接缝合13例,补片修补5例;动脉导管未闭（PDA）1例采用直视缝合方法.肺动脉瓣成形术3例,法乐四联症根治术1例,主动脉瓣置换手术3例,二尖瓣置换术1例,三尖瓣置换术1例.结果 全组经手术及抗生素治疗后均痊愈出院.随访3～ 18个月,无死亡及心内膜炎复发.结论 正确把握手术时机、手术方式及选择有效抗牛索是提高先天性心脏病合并感染性心内膜炎治愈率的关键.

Objective To analyse the effect of surgical treatment of 24 cases suffered from congenital heart disease with infective endoearditis. Methods The operation in 24 cases of congenital heart disease with infective endoearditis was deformity correction and vegetation removal in extracorporeal circulation, 1 case in which was direct suture ventrieular septal defect （VSD） ,5 cases in which were patch repair of veutricular septal defect （VSD）, 3 cases in which were pul- monary valvuloplasty, 1 case in which was tetralogy of Fallot radical surgery, 3 cases in which were aortic valve replace- ment surgery, two cases in which were mitral valve replacement, 1 cases in which was tricuspid valve replacement surgery. Results All cases were treated with surgical treatment and antibiotics and after 3 to 18 - month follow - up, no patients were dead and showed no relapse. Conclusion Correctly grasping the timing of surgery, surgical approach and choice of effective antibiotics is the key to improving the cure rate.