内外科综合治疗感染性心内膜炎

目的探讨内、外科综合治疗感染性心内膜炎的价值。方法对62例感染性心内膜炎,术前使用大剂量青霉素与庆大霉素,其中15例行急诊手术,16例行亚急诊手术,31例行择期手术。手术主要清理赘生物、被感染的瓣膜组织及瓣周脓肿,并矫治心内病变。结果无手术死亡。术后死亡4例,58例治愈出院。除3例失访外,其余随访2年心功能均恢复到Ⅰ~Ⅱ级。结论在抗感染同时积极采取外科干预治疗能有效降低感染性心内膜炎的病死率。

Infective Endocarditis Comprehensively Treated with Internal Medicine and Surgery

Objective To discuss the significance of comprehensive treatment with internal medicine and surgery for infective endocarditis.Methods A total of 62 patients with infective endocarditis were administered the large dose of penicillin and gentamicin before surgical operation.Of the patients,15 were performed with emergency operation,16 with sub-emergency operation,and 31 with elective surgery.The surgical operation consisted mainly of the clearance of vegetation and infected valvular tissue,and the repair of intracardiac lesion.Results None died during the operation.Four patients died after operation,and the other 58 ones left the hopital when healed up.According to the two years' follow-up,an improvement in cardiac function to grade Ⅰ or Ⅱ was achieved in all the 58 patients except the three ones who lost follow-up.Conclusion The case-fatality rate of infective endocarditis can be effectively lowered as soon as active surgical intervention is employed in addition to anti-infection.