外科治疗感染性心内膜炎

目的总结56例外科治疗感染性心内膜炎（IE）的经验。方法全组56例，男性43例，女性13例，年龄10-75岁，病史5d至8个月，平均1．3个月。临床表现均有程度不等的发热、心悸、气急等症状，其中急性心衰伴进行性加重不能控制者19例、脾肿大及皮肤出血18例、持续高热不退者15例、动脉栓塞者7例、传导阻滞者4例、血培养阳性者15例。全组均在体外循环下施行心内直视手术，其中左房室瓣置换24例、双瓣膜置换19例、主动脉瓣置换7例、右房室瓣成形3例、右房室瓣置换2例、Bentall手术1例，同期矫治合并其他心血管畸形8例。急诊手术占34％（19／56）。结果早期死亡4例（7．2％），其中3例为低心排综合征，1例为人工瓣膜感染性心内膜炎；晚期死亡2例。长期存活50例，心功能均为Ⅰ～Ⅱ级。结论对IE应积极手术治疗，尤其需要在血流动力学及瓣膜条件恶化前手术；急性心衰伴进行性加重不能控制者外科治疗仍有较理想手术疗效。

The surgical treatment of infective endocarditis

Objective To summarize the surgical treatment experience of 56 cases infective endocarditis.Methods It included 43 male and 13 female patients aged 10-75 years.The duration of disease was 5 days to 8 months(averaged 1.3 months) .Patients had different degree fever,palpitation,short breath,et al.There were 19 patients with acute progressive heart failure which couldn't be controlled and 15 patients with lasting high fever.And 7 patients had arterial embolism,and 4 patients had heart conduction block.Blood cu...