经手术及病理证实的感染性心内膜炎38例临床分析

Clinical analysis of 38 cases of infective endocarditis proved by surgery and pathology

目的 :探讨Duke诊断标准和小儿感染性心内膜炎的诊断标准 (试行 )对感染性心内膜炎的诊断价值及感染性心内膜炎的有效治疗方法。方法 :总结我院自 1985年至 2 0 0 1年收治并经手术及病理证实的感染性心内膜炎 38例。结果 :1.按Duke诊断标准 :确定诊断 17例 ;疑似诊断 2 0例 ,排除诊断 1例。按小儿感染性心内膜炎的诊断标准 (试行 ) :确定诊断 36例 ,疑似诊断 2例。 2 .6例行急诊手术 ,3例痊愈。结论 :1.小儿感染性心内膜炎的诊断标准 (试行 )对感染性心内膜炎诊断的敏感性优于Duke诊断标准。2 .对于危重患者 ,急诊手术是有效的治疗方法。

Objective:To explore value of the Duke criteria and the criteria formulated in 2000 by the group of cardiovasology, branch of pediatrics, Chinese Medical Association and the Edit Committee of Chinese Journal of Pediatrics (new criteria) and effective treatment of infective endocarditis(IE).Method:To review the clinical characters, diagnosis and treatment of 38 cases of infective endocarditis proved by surgery and pathology from 1985 to 2001 in Beijing An Zhen Hospital. All cases are classified and analyzed by using the two criterias mentioned above. Result:1. Diagnosis by using the Duke criteria: 17 cases were definitely diagnosed. 20 cases were classified as possible IE and 1case was ruled out from the diagnosis of IE. 2. According to the new criteria: 36 cases were definitely diagnosed. 2 cases were classified as possible IE. 3. 6 cases were recieved urgent surgical intervention, 3 cases of them were recuperated.Conclusion:1. The sensitivity of new criteria for the diagnosis of IE is better than Duke criteria. 2. The urgent surgical intervention is an effective way when the patient is with uncontrolled infection and progressive congestive heart failure. [