佛山地区感染性心内膜炎病例及手术特点分析

The Analysis of Infective Endocartitis Cases in Foshan and Its Surgical Characteristics

目的分析佛山地区感染性心内膜炎患者术前和手术情况,综合既往文献,对于该疾病的预防、诊断和治疗方法进行探讨。方法收集2014年1月～2018年1月,佛山市第一人民医院(中山大学附属佛山医院)心脏外科手术治疗的60例感染性心内膜炎患者的资料,并进行回顾性总结。结果 2例患者术后死亡,1例为术后无法纠正的低心排综合征患者,1例为热带念珠菌感染的患者,术后反复高热,多器官衰竭死亡。其余58例患者预后良好,无瓣周漏发生。结论对于有发热、心脏瓣膜有杂音患者,应该考虑到感染性心内膜炎的可能,应进行规范的血培养和心脏彩超,必要时进行经食道彩超检查。符合外科手术指证患者,特别是金黄色葡萄球菌感染患者,应该早期进行外科手术治疗。对于高危人群,在进行口腔治疗等操作时应该预防性使用抗生素。

Objective To analyze the cases of infective endocartitis in Foshan and its surgical characteristics and to conclude strategies of the prevention,diagnosis and treatments of the disease by reviewing the previous literature. Methods Data of 60 patients with infective endocarditis treated by heart surgery in the First People's Hospital of Foshan from January 2014 to January 2018 were collected and studied. Results There were 2 cases of postoperative death,including one patient developed low cardiac output syndrome after surgery,and another patient had repeated hyperthermia after surgery and died of multiple organ failure.The rest of the patients had good prognosis without perivalvular leak. Conclusions For patients with fever and cardiac valve murmurs,standard blood culture and cardiac echocardiography or transesophageal cardiac echocardiography should be carried out.Patients with surgical indications,especially those with staphylococcus aureus infection,should undergo surgical treatment early.For high-risk groups,antibiotics should be used prophylactically during oral operations.