超声心动图在小儿感染性心内膜炎诊断治疗中的临床价值分析

The clinical value of echocardiography in pediatric diagnosis and treatment of infective endocarditis analysis

目的探究超声心动图在小儿感染性心内膜炎临床诊治中的作用,以期提高疗效,降低感染。方法选择2011年5月至2014年5月医院治疗的70例小儿感染性心内膜炎患者,观察血培养后病原菌分布情况,观察病因、临床表现情况和超声心动图征象。结果感染性心内膜炎病因中以先天性心脏病最常见,占61.43%;病原菌上,70例感染性心内膜炎患者中培养出菌株89株,其中革兰阳性菌28株,革兰阴性菌61株,革兰阳性菌中草绿色链球菌最多,占17.98%,革兰阴性菌中大肠埃希菌占24.72%,肺炎克雷伯菌占16.85%;超声心动图上,阳性率95.71%,其中以主动脉赘生物最常见,占41.43%,二尖瓣赘生物占25.71%;治疗后在主动脉瓣、二尖瓣、三尖瓣赘生物,主动脉瓣和二尖瓣均有赘生物上较治疗前明显下降,在瓣膜穿孔上也明显下降,治疗前后比较差异有统计学意义(P<0.05)。结论超声心动图能明确感染性心内膜炎病变情况,能直观判断预后情况,可作为临床诊治首选方法。

Objective To explore the echocardiography clinical diagnosis and treatment of infective endocarditis in children in order to improve the efficacy and reduce infection. Methods From May 2011 to May 2014, the hospital treated 70 cases of pediatric patients with infectious endocarditis, blood cultures were observed in the distribution of pathogens, observe etiology, clinical manifestations situation and echocardiographic signs. Results The etiology of infective endocarditis with congenital heart disease the most common, accounting for 61.43%;the pathogens, 70 cases of infective endocarditis in patients cultured strains 89, wherein 28 Gram-positive bacteria, Gram 61 Gram-negative bacteria, Gram-positive bacteria Streptococcus viridans most, accounting for 17.98%, Gram-negative bacteria Escherichia coli accounted for 24.72%, accounting for 16.85% of Klebsiella pneumoniae;echocardiography, the positive rate 95.71%, of which the most common neoplasm aorta, accounting for 41.43%, accounting for 25.71% of mitral vegetation;after treatment, the aortic valve, mitral valve, tricuspid valve vegetations, aortic and mitral valves are there vegetation before treatment decreased significantly, also decreased significantly in the valve perforation, before and after treatment difference was statistically significant (P<0.05). Conclusion Echocardiography can clear infective endocarditis lesions, can directly determine the prognosis, clinical diagnosis and treatment as the preferred method.