32例感染性心内膜炎治疗的临床分析

目的探讨左心IE与右心IE两者临床表现及治疗上的差异。方法对中山大学第二附属医院2000年1月～2004年12月住院的32例IE病人分成左心IE组、右心IE组进行回顾性对照分析。结果左心IE中内科治疗15例,其中治愈4例;外科治疗10例并全部治愈,其中行瓣膜置换术9例,瓣膜修复整形术1例;右心IE中内科治疗2例,其中治愈1例;外科治疗5例,其中行三尖瓣置换术4例,三尖瓣膜修复整形术1例;手术治疗5例中治愈4例,1例因术后多器官功能障碍综合症死亡。结论右心IE与左心IE临床表现不同,突出表现在肺部病变:右心IE表现为急性肺炎或肺栓塞的临床症状;左心IE表现为瓣膜功能障碍。对于IE瓣膜病变的手术方式应根据瓣膜损坏程度来决定,左心IE以瓣膜置换为主,右心IE尽量争取瓣膜修复整形。

Clinical analysis on the treatment of 32 cases with infective endocarditis

Objective To investigate the deferences between left,sided infective endocarditis(IE) and right,sided infective endocarditis in clinical manifestations and therapies. Methods 32 cases with IE being diagnosed from 1999 to 2004 were divided into left,sided infective endocarditis group and right,sided infective endocarditis group. Results In left,sided IE group 15 cases underwent antibiotic therapy and 10 cases blonged to surgical treatment. Valve replacement was performed in 9 case and repair of mitral valve in 1 case. In right,sided IE 2 cases belonged to antibiotic therapy and 5 cases surgical treatment. Tricuspid replacement was performed in 4 case and repair of tricuspid valve in 1 case. Conclusion The clinical manifestation between left,sided IE and right,sided IE are different;The operative ways of IE depend on the degree of valve lesions. The operative way for right,sided IE is valve repair as far as possible whereas valve replacement is main operative way for left,sided IE.