超声心动图在感染性心内膜炎赘生物及其他并发症中的诊断价值

Value of echocardiography in diagnosis of infective endocarditis neoplasm and other complications

目的探讨超声心动图在感染性心内膜炎赘生物及其他并发症中的诊断价值,为临床有效诊断提供依据。方法研究选取医院在2008年7月-2011年10月住院治疗的感染性心内膜炎患者76例,所有入组患者均行超声心动图、手术及病理检查,将检查结果进行统计分析。结果 76例患者行急诊手术4例占5.26%,择期手术72例占94.74%,手术成功74例占97.37%,死亡2例占2.63%;76例患者超声心动图检查发现赘生物35例,阳性率77.77%,赘生物<2mm有1例、2～15mm有31例、>15mm有3例;发现1个赘生物12例(其中4例为假阳性)、2个20例、≥3个3例;超声心动图检查受累瓣膜阳性率82.98%,其中二尖瓣受累26例、主动脉瓣受累23例、二尖瓣及主动脉同时受累9例、其他瓣膜受累3例,瓣周漏及脓肿各2例,瓣膜脱垂11例(其中2例为假阳性),瓣膜穿孔2例。结论超声心动图能对心脏赘生物进行准确定位,并能确定其大小、形态、数目及伴随的心脏情况,还能提供感染性心内膜炎有无心脏基础病变、并发症及相应的血流动力学改变等可靠的诊断依据,为临床提供详实的资料。

OBJECTIVE To explore the diagnostic value of echocardiography in infective endocarditis vegetation and other complications so as to provide basis for effective clinical diagnosis.METHODS A total of 76 patients with infective endocarditis from Jul 2008 to Oct 2011 were chosen as the research objects.All the patients underwent echocardiography,surgery and pathological examination.The test results were statistically analyzed.RESULTS Totally 4（5.26%） cases underwent emergency surgery in 76 patients,elective surgery in 72 cases（94.74%）,the operation was successful in 74 cases（97.37%）,the death was in 2 cases（2.63%）;totally 35 cases of neoplasm were found by echocardiography in 76 patients with the positive rate of 77.77%.There was 1 case with size 2 mm,31 cases with 2-15 mm,and 3 cases with size 15 mm;the involvement valva positive rate was 82.98%,26 cases were of mitral valve,23 cases was of aortic,mitral and aortic at the same time was with nine cases,three cases were of the others,paravalvular leakage was in two cases,abscess was in two cases,and prolapse was in 11 cases,two cases were of false positives,and valvular perforation was in two cases.CONCLUSION The echocardiography can not only accurately locate and determine the size,shape,number and accompanying heart condition for heart vegetation,but also provide a reliable diagnosis for the basis lesions of infective endocarditis with or without heart complications and the corresponding blood hemodynamic changes as well as a detailed information for clinical application.