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 4 1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 2 3例 ,女 18例 ,平均年龄 2 2 6岁 ,术前 2 7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。结论 :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. Twnety 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 resuls were satisfactory. One patient (2.4%) died during hospitalzation. 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.