外科手术治疗原发性感染性心内膜炎疗效观察

Observation on therapeatic effect of surgical treatment for infective endocarditis

目的：探讨手术治疗原发性感染性心内膜炎的近远期效果。方法对2002年1月-2013年6月连续收治的符合 Duke 诊断标准的原发性感染性心内膜炎患者16例进行回顾性研究。主要终点事件为与感染性心内膜炎相关性死亡、二次手术、感染性心内膜炎复发。结果16例患者中男12例，女4例，男女比为3∶1，年龄25．0～60．6（46．7±13．9）岁，行二尖瓣置换术9例，主动脉瓣置换术4例，二尖瓣主动脉瓣联合置换术3例，30 d 内病死率为18．8％（3/16）。随访12例，随访时间0～137（42．3±5．0）月，5年生存率为80．0％，远期死亡原因主要为心功能不全、感染性心内膜炎复发。结论感染性心内膜炎仍是高病死率疾病，心脏彩色超声可以提高其诊断率，早期手术有利于提高远期效果。

Objective To evaluate the impact of surgical treatment for infective endocarditis in short and long term period.Analysis the risk facts of in hospital mortality .Methods From January 2002 to June 2013, consecutive 16 cases who meets Duke diagnostic criteria and treated with primary infective endocarditis were studied retrospectively .The primary end-point events with infective endocarditis -related include death, reoperation, and infective endocarditis recurrence .Results 16 patients included 12 males and 4 females, male to female ratio was 3∶1, age 25.0 -60.6 （46.7 ＆#177;13.9） years old, mitral valve replacement in 9 patients, 4 cases of aortic valve replacement , mitral combined aortic valve replacement with three ca -ses, 30 d mortality rate was 18.8% （3 /16）.Follow-up of 12 cases, follow-up time 0 -137 （42.3 ＆#177;5.0） months, the 5-year survival rate was 80.0%, the main cause of late death was heart failure , infective endocarditis recurrence .Conclusion Infective endocarditis is still a high mortality disease , heart color ultrasound can improve the diagnosis rate of early surgical help to improve the long-term effects.