感染性心内膜炎外科治疗34例
Surgical therapy for infective endocarditis: report of 34 cases
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摘要: 目的:总结感染性心内膜炎(infective endocarditis,IE)的外科治疗经验,评价治疗效果。方法:34例中行二尖瓣置换术9例,主动脉瓣置换术12例,双瓣置换术6例,三尖瓣置换术1例,三尖瓣心包重建术1例,室间隔缺损修补术3例,房间隔缺损修补术1例,瓦氏窦瘤破裂合并室间隔缺损修补术1例,其中3例为急诊手术。结果:治愈32例,术后随访1~5年,无复发及死亡;术后早期因多器官功能衰竭死亡2例。结论:根据多次血培养及超声心动图检查,可明确IE的诊断,围手术期的正确处理及手术过程中的针对性操作是手术成功的关键。Abstract: Objective: To summarize the experience in treatment of infective endocarditis(IE) by surgical operation and to evaluate the curative effect.Methods: Among 34 patients with IE,mitral valve replacement was performed in 9 cases,arotic valve replacement in 12,double valve replacement in 6,tricuspid valve replacement in 1,tricuspid valve reconstruction in 1,ventricular septal defect neoplasty in 1,atrial septal defect neoplasty in 1 and VSD with ruptured aortic sinus aneurysm in 1.And 3 of the cases received emergency operation.Results: Thirty-two of the cases were cured.The follow-up lasted from one to five years,with no record of recurrence or death.The cause of 2 deaths after operation was multiple organ system failure.Conclusions: Precise diagnosis of IE depends on hemoculture and ultrasound cardiogram;the key to sucessful operations are proper management during perioperative period and purposeful procedure in operation.