吸毒病人感染性心内膜炎的外科治疗

The experince of surgical management in drug addictive patients with infectious endocarditis

目的 总结吸毒病人感染性心内膜炎的外科治疗经验。方法 12例均有右房室瓣赘生物 ,5例中度右房室瓣关闭不全 ,7例重度右房室瓣关闭不全。均在体外循环下行右房室瓣病灶、赘生物清除、瓣膜整形术。结果 12例全部康复出院 ,其中有 2例术后B超复查 ,有轻度右房室瓣关闭不全。结论 感染性心内膜炎出现赘生物和进行性充血性心力衰竭以及感染不能控制时应及早外科手术治疗 ,清除赘生物病灶并作右房室瓣整形手术纠治 ,可获满意效果。

Objective To summaize the experience of surgical management in drug addictive patients with infectious endocarditis.Methods Vegetations were found in all the 12 patients with right valvular insufficiency(moderate in 5 cases and severe in 7 cases).Reparetive technique with resecting of vegetations under CPB were performed in all of these cases.Results The patients recovery uneventfully without death.Two cases developed valvular insuffioiency after operation.Conclusion Early surgical management of infectious endocarditis in patients with valvular insufficiency and CHF,vegetations is necessary.The results of reparative technique with resecting of vegetations is satisfactory.