先天性心脏病合并感染性心内膜炎的外科治疗

潘文成; 王学锋; 王伟; 肖颖彬; 王咏

doi:10.16016/j.1000-5404.202007235

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先天性心脏病合并感染性心内膜炎的外科治疗

心脏外科临床研究 | 更新时间：2026-01-09

- 先天性心脏病合并感染性心内膜炎的外科治疗
- Surgical treatment for congenital heart disease complicated with infective endocarditis
- 第三军医大学学报 2021年43卷第2期页码：96-100
- 作者机构：
  
  400037 重庆, 陆军军医大学(第三军医大学)第二附属医院全军心血管外科研究所
- 作者简介：
  
  [ 王咏，E-mail:wy003236@163.com WANG Yong, E-mail: wy003236@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202007235
  中图分类号： R541.1;R542.41;R642.2
- 收稿：2020-07-29，
  
  修回：2020-10-19，
  
  纸质出版：2021-01-30
- 稿件说明：
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潘文成, 王学锋, 王伟, 等. 先天性心脏病合并感染性心内膜炎的外科治疗[J]. 第三军医大学学报, 2021,43(2):96-100.

Wencheng PAN, Xuefeng WANG, Wei WANG, et al. Surgical treatment for congenital heart disease complicated with infective endocarditis[J]. Journal of Third Military Medical University, 2021, 43(2): 96-100.
潘文成, 王学锋, 王伟, 等. 先天性心脏病合并感染性心内膜炎的外科治疗[J]. 第三军医大学学报, 2021,43(2):96-100. DOI： 10.16016/j.1000-5404.202007235.

Wencheng PAN, Xuefeng WANG, Wei WANG, et al. Surgical treatment for congenital heart disease complicated with infective endocarditis[J]. Journal of Third Military Medical University, 2021, 43(2): 96-100. DOI： 10.16016/j.1000-5404.202007235.

摘要

目的

探讨先天性心脏病合并感染性心内膜炎的临床特点及外科治疗经验。

方法

回顾性分析2015年1月至2019年12月我院心血管外科收治并行手术治疗的83例先天性心脏病并发感染性心内膜炎患者的临床资料及围术期治疗、手术方法。

结果

术后早期死亡2例，病死率2.4%，家属放弃救治2例，余患者顺利出院。术后最常见并发症为心衰(16.9%)、Ⅲ度/高度房室传导阻滞(8.4%)。随访3个月至5年，4例残余分流，其中2例自愈，6例人工瓣膜流速增快，无患者感染性心内膜炎复发，无患者需再次手术干预治疗。

结论

早期发现及规范的抗感染治疗，多学科团队合作，选择合适的手术时机，合理的手术方案，可取得良好的治疗效果。

Abstract

Objective

To summarize the clinical characteristics and surgical treatment experience of congenital heart disease complicated with infective endocarditis.

Methods

The clinical data including perioperative management and surgical approaches of 83 cases of congenital heart disease with active infective endocarditis admitted to the Department of Cardiovascular Surgery of our hospital between January 2015 and December 2019 were collected and retrospectively analyzed.

Results

Among the 83 patients enrolled

early postoperative death occurred in 2 cases

with an in-hospital mortality rate of 2.4%

2 cases were discharged voluntarily due to abandonment by their family member

and the remaining 79 patients recovered well. The 2 most common postoperative complications were heart failure (16.9%) and grade Ⅲ atrioventricular block (8.4%). During the follow-up of 3 months to 5 years

residual shunt occurred in 4 cases

with 2 of them being confirmed closed spontaneously

and peak prosthetic velocity and mean gradient increase occurred in 6 cases. No endocarditis recurred and none of the above so far needed surgical reintervention.

Conclusion

Early detection and standard anti-infection treatment

multidisciplinary team cooperation

appropriate timing of surgery

and retinal surgical procedure are the key factors to achieve good clinical efficacy.

关键词

Keywords

references

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