120例感染性心内膜炎的外科治疗_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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刘成硅 , 董念国 , 孙宗全等

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Keywords：

感染性心内膜炎; 外科手术; 围术期处理

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目的总结 120例感染性心内膜炎（ IE）的围术期处理经验，探讨手术时机和方法。方法回顾性分析华中科技大学附属协和医院 2006年 1月至 2011年 4月 120例感染性心内膜炎患者接受手术治疗的临床资料，男 75例，女 45例；年龄 4～ 73（44±3）岁。以发热为主就诊 36例，术前心功能不全 54例，脑栓塞 10例，血培养阳性 20例，超声心动图证实心内有赘生物形成 111例。所有患者均在体外循环下进行赘生物清除、心瓣膜置换术及原发心脏病矫正手术。术后继续使用抗生素治疗 4～ 6周。结果全组患者术后住院时间 14～ 60（20±6）d，无手术死亡。全组术后死亡 5例；生存出院 115例，出院患者随访 3个月～ 4年，均恢复良好。术后发生并发症 20例，再次手术患者 2例。结论感染性心内膜炎应做到早发现、早诊断、早治疗，并掌握好手术时机和原则，恰当的围手术期处理，可取得良好的效果。

Citation： 刘成硅,董念国,孙宗全等. 120例感染性心内膜炎的外科治疗. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(3): 323-325. doi: Copy

1.	Chu VH, Cabell CH, Benjamin DK, et al. Early predictors of in-hospital death in infective endocarditis. Circulation, 2004, 109 （14）：14-20.
2.	郑家豪, 薛松, 黄日太, 等. 人工瓣膜感染性心内膜炎的诊断与治疗. 中国胸心血管外科临床杂志, 2010, 17 （5）：377-380.
3.	Delahaye F. Is early surgery beneficial in infective endocarditis? A systematic review. Arch Cardiovasc Dis, 2011, 104 （1）：35-44.
4.	Newton S, Hunter S. What type of valve replacement should be used in patients with endocarditis? Interact Cardiovasc Thorac Surg, 2010, 11 （6）：784-788.
5.	Thuny F, Habib G. When should we operate on patients with acute infective endocarditis? Heart, 2010, 96 （11）：892-897.
6.	Head SJ, Mokhles MM, Osnabrugge RL, et al. Surgery in current therapy for infective endocarditis. Vasc Health Risk Manag, 2011, 7：255-263.
7.	Takahashi Y, Tsutsumi Y, Monta O, et al. Acute mitral valve regurgitation due to complete rupture of anterior papillary muscle mimicking mitral valve vegetation. Ann Thorac Cardiovasc Surg, 2011, 17 （1）：81-85.
8.	Montasser D, Bahadi A, Zajjari Y, et al. Infective endocarditis in chronic hemodialysis patients：experience from Morocco. Saudi J Kidney Dis Transpl, 2011, 22 （1）：160-166.
9.	Rostagno C, Rosso G, Puggelli F, et al. Active infective endocarditis： clinical characteristics and factors related to hospital mortality. Cardiol J, 2010, 17 （6）：566-573.
10.	Pharis CS, Conway J, Warren AE, et al. The impact of 2007 infective endocarditis prophylaxis guidelines on the practice of congenital heart disease specialists. Am Heart J, 2011, 161 （1）：123-129.
11.	Morokuma H, Minato N, Kamohara K, et al. Three surgical cases of isolated tricuspid valve infective endocarditis. Ann Thorac Cardiovasc Surg, 2010, 16 （2）：134-138.
12.	Lin T, Santos M, Aboltins C, et al. A case of intra-cardiac right-sided mural infective endocarditis associated with ventricular septal defect despite prophylactic antibiotics：a case report. Heart Lung Circ, 2010, 19 （9）：566-571.
13.	Cooper HA, Thompson EC, Laureno R, et al. Subclinical brain embolization in left-sided infective endocarditis：results from the evaluation by MRI of the brains of patients with left-sided intracardiac solid masses （EMBOLISM） pilot study. Circulation, 2009, 120 （7）：585-591.

1. 　Chu VH, Cabell CH, Benjamin DK, et al. Early predictors of in-hospital death in infective endocarditis. Circulation, 2004, 109 （14）：14-20.
2. 　郑家豪, 薛松, 黄日太, 等. 人工瓣膜感染性心内膜炎的诊断与治疗. 中国胸心血管外科临床杂志, 2010, 17 （5）：377-380.
3. 　Delahaye F. Is early surgery beneficial in infective endocarditis? A systematic review. Arch Cardiovasc Dis, 2011, 104 （1）：35-44.
4. 　Newton S, Hunter S. What type of valve replacement should be used in patients with endocarditis? Interact Cardiovasc Thorac Surg, 2010, 11 （6）：784-788.
5. 　Thuny F, Habib G. When should we operate on patients with acute infective endocarditis? Heart, 2010, 96 （11）：892-897.
6. 　Head SJ, Mokhles MM, Osnabrugge RL, et al. Surgery in current therapy for infective endocarditis. Vasc Health Risk Manag, 2011, 7：255-263.
7. 　Takahashi Y, Tsutsumi Y, Monta O, et al. Acute mitral valve regurgitation due to complete rupture of anterior papillary muscle mimicking mitral valve vegetation. Ann Thorac Cardiovasc Surg, 2011, 17 （1）：81-85.
8. 　Montasser D, Bahadi A, Zajjari Y, et al. Infective endocarditis in chronic hemodialysis patients：experience from Morocco. Saudi J Kidney Dis Transpl, 2011, 22 （1）：160-166.
9. 　Rostagno C, Rosso G, Puggelli F, et al. Active infective endocarditis： clinical characteristics and factors related to hospital mortality. Cardiol J, 2010, 17 （6）：566-573.
10. 　Pharis CS, Conway J, Warren AE, et al. The impact of 2007 infective endocarditis prophylaxis guidelines on the practice of congenital heart disease specialists. Am Heart J, 2011, 161 （1）：123-129.
11. 　Morokuma H, Minato N, Kamohara K, et al. Three surgical cases of isolated tricuspid valve infective endocarditis. Ann Thorac Cardiovasc Surg, 2010, 16 （2）：134-138.
12. 　Lin T, Santos M, Aboltins C, et al. A case of intra-cardiac right-sided mural infective endocarditis associated with ventricular septal defect despite prophylactic antibiotics：a case report. Heart Lung Circ, 2010, 19 （9）：566-571.
13. 　Cooper HA, Thompson EC, Laureno R, et al. Subclinical brain embolization in left-sided infective endocarditis：results from the evaluation by MRI of the brains of patients with left-sided intracardiac solid masses （EMBOLISM） pilot study. Circulation, 2009, 120 （7）：585-591.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

120例感染性心内膜炎的外科治疗

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