感染性心内膜炎65例外科治疗

Surgical treatment of infective endocarditis in 65 cases

目的:探讨感染性心内膜炎 (IE)手术治疗的适应证 ,减少病人的早期及晚期病死率。方法 :6 5例 IE病人经静脉滴注大剂量抗生素 1～ 2周感染未能控制 ,于感染活动期施行主动脉瓣置换术 2 5例 ,二尖瓣置换术 2 3例 ,三尖瓣修复成形术 3例 ,肺动脉瓣成形术 2例 ,室间隔缺损修补术 11例 ,法乐氏四联症矫正术 1例。结果 :本组无手术死亡及术后早期死亡。随访 3～ 6个月均无心内膜炎复发 ,心功能恢复至 ～ 级。结论:当 IE无法控制 ,尤其是出现无法控制的心力衰竭时 ,尽早手术可以提高治愈率。

Objective: To review the experiences in surgical treatment in infective endocarditis. Methods: There were 65 patients with infective endocarditis treated with surgical procedures in our hospital in 15 years. Among them,aortic value replacement in 25,mitral value replacement in 23,tricuspaid value reconstraction in 3 and pulmonary value repair in 2,congenital heart defect correction in 11,and 1 with tetralogy of fallot. Results: There was no postoperative and overall hospital death. Conclusions: Diagnostic and appropriate timing of operation,experienced surgical technique were the main determinates in affecting the prognosis of the patients with infective endocarditis.