【摘要】 目的探讨先天性心脏病(CHD)继发感染性心内膜炎(IE)的诊断和外科治疗。方法根据临床表现、血培养和超声心动图检查明确诊断CHD继发IE患者36例,总结其临床特征、诊断和外科治疗经验。结果择期手术30例,急诊手术6例。手术彻底清除感染病灶,重建受损心内结构,同时矫治原发先天性心脏畸形。手术过程顺利,术后早期死亡2例,病死率为5.6%。其余34例患者均痊愈出院。术后并发低心排综合征3例,急性肾功能不全1例,室上性心律失常1例,经药物治疗后痊愈。1例动脉导管未闭缝合术喉返神经损伤,并发永久性声音嘶哑。结论积极的外科手术、完善的围手术期处理是治疗CHD继发IE的重要手段。更多还原

【Abstract】 Objective To investigate the diagnosis and surgical treatment of infective endocarditis (IE) in patients with congenital heart disease (CHD).Methods The data of 36 patients diagnosed according to clinical symptoms,the results of blood culture and echocardiogram and treated in our department,were analyzed retrospectively.Results Of 36 cases,30 patients received selective operation and 6 patients emergent operation.Operations were successful in eliminating infective focus thoroughly,reconstructing impaired intra cardiac construction,and treating the malformation of CHD.Two patients were died at early period after operation with a mortality of 5.6%.After operation there were 2 patients with low cardiac output syndrome,1 patient with acute renal dysfunction,1 patient with supraventricular arrhythmia,which were cured by medication.However,1 patient had hoarse voice permanently due to hurting the recurrent laryngeal nerve.Conclusion The active surgical treatment and perfect perioperative management are the important ways to treat IE in patients with CHD.更多还原