感染性心内膜炎外科治疗34例

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。

Surgical therapy for infective endocarditis:report of 34 cases

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.