先天性心脏病并发感染性心内膜炎的外科治疗

目的：总结我院手术治疗的41例先天性心脏病（先心病）并发感染性心内膜炎（IE）的诊断和治疗经验。方法：男23例，女18例，平均年龄22．6％，术前27例进行了血细菌培养，其中阳性11例（41％）。34例在感染控制后手术，7例于感染活动期手术。所有病例均彻底清除感染灶，纠治先心病及瓣膜病变。结果：术后早期死亡1例，死亡率2．4％，其余远期效果良好。结果：先心病并发IE发生率有上升趋势；超声心电图在诊断上有重要作用；常规血培养有假阴性结果；对先心病并发心内膜炎患者的手术治疗应采取积极态度。

Surgical treatment of congenital heart disease complicated with infective endocarditis]

OBJECTIVE: To review the experience of surgical treatment and the diagnosis of 41 patients with congenital heart diseases complicated with infective endocarditis. METHODS: Twenty-three males and 18 females (the mean age 22.6 years) were studied. Twenty-seven patients received bacterial cultivation of blood specimens, and the results of bacterial cultivation of 11 patients were positive. Thirty-four patients underwent cardiac operations after infection was almost controlled, and 7 patients underwent operations during the infective phase. In all the cases, the infected tissues were excised, congenital cardiac was treated, and valvular dysfunctions were corrected. RESULTS: The surgical treatment results were satisfactory. One patient (2.4%) died during hospitalization. CONCLUSION: In our hospital, the incidence rate of infective endocarditis complicated with congenital heart diseases increases; echocardiography is a valuable tool in diagnosis; blood culture may be negative after previous administration of antibiotics; aggressive surgical treatment should be adopted in patients with congenital heart defects complicated with infective endocarditis.