感染性心内膜炎104例的临床分析

CLINICAL ANALYSIS OF 104 PATIENTS WITH INFECTIVE ENDOCARDITIS PATIENTS

分析 10 4例感染性心内膜炎 (IE)的临床资料 ,其中先心病 75例 (72 1% ) ,风心病 2 1例 (2 0 2 % ) ,心脏无基础病变 8例(7 7% )。结果提示 :①先心病的早期诊断、早期手术根治是减少IE发生的主要预防措施 ;②发热、贫血、栓塞、肝大和脾大等的发生率显著降低 ;③赘生物侵犯主动脉瓣的概率 (44 2 % )高于二尖瓣 (2 4 7% ) ,且主动脉瓣IE多起病急 ,进展快 ,短期进展为顽固性心力衰竭 ,唯有尽早行瓣膜替换术 ;④抗生素的广泛应用使血培养阳性率下降 ;⑤适当的内科治疗与积极的外科治疗相结合是IE治疗的重要手段。

patients with infective endocarditis were analyzed. Anong them, 75 were patients with congenital heart disease (72 1%), 21 were patients with rheumatic heart disease and 8 were patients without heart disease(7 7%). It is suggested that early diagnoses and treatment of CHD are the main pretective methods for reducing the incidence of IE; the incidence of fever, anaemia, embolism, hepatomegaly and splenomegaly, etc. declines notably; the possibility of excrescence invading aortic valve (44 2%) is higher than that of mitral valve (24 7%), and IE of aortic valve results in heart failure in a short while and the valve replacement should be done as early as possible; positive rate of blood culture declines because of extensive use of antibiotics; appropriate medical treatment combined with active surgical treatment plays an important role in the treatment of IE.