临床外科杂志 ›› 2019, Vol. 27 ›› Issue (8): 677-679.doi: 10.3969/j.issn.1005-6483.2019.08.015

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三尖瓣感染性心内膜炎的外科治疗

  

  1. 430022 武汉亚洲心脏病医院心血管外科
  • 出版日期:2019-08-20 发布日期:2019-08-20

Surgical therapy for infective endocarditis on the tricuspid valve

  1. Department Cardiovascular Surgery,Wuhan Asia Heart Hospital,Wuhan 430022,China
  • Online:2019-08-20 Published:2019-08-20

摘要: 目的 分析三尖瓣感染性心内膜炎的外科治疗效果。方法 回顾性分析接受心血管外科手术治疗的右心感染性心内膜炎病人51例的临床资料,所有病人在体外循环下行赘生物清除、合并心脏畸形矫治及三尖瓣手术,术后抗生素使用2~4周。结果 术后1例病人二次开胸止血,1例病人术后1年出现二尖瓣赘生物,1例病人术后3个月间断发热持续4年再次出现三尖瓣赘生物行二次手术,1例病人术后蛛网膜下腔出血、急性肾损害、败血症转院,50例病人治愈出院,随访6个月~13年,病人心力衰竭症状明显改善,2例复发。结论 通过外科手术可有效治疗由先天性心脏病、瓣膜病或做过心脏手术引起的三尖瓣感染性心内膜炎,并得到满意效果。

关键词: 心内膜炎, 三尖瓣, 心血管外科手术

Abstract: Objective To summary and analysis of the surgical treatment and effect of tricuspid valve infective endocarditis.Methods The clinical data of 51 patients with right heart infective endocarditis treated by cardiovascular surgery were retrospective analyzed.All patients underwent extracorporeal circulation of neoplasm removal,combined with cardiac deformity correction and tricuspid valve surgery,postoperative antibiotics for 2~4 weeks.Result Secondary thoracotomy in one patient postoperative bleeding,one of patients with postoperative year mitral valve vegetations,one of patients with postoperative March intermittent fever lasted 4 years again three tricuspid valve vegetations two operation,one of patients with subarachnoid hemorrhage,acute kidney injury,sepsis,referral.50 cases of patients were cured and discharged,followed up for 6 months to 13 years,the symptoms of heart failure were obviously improved and 2 cases had relapsed.Conclusion Surgery can effectively treat tricuspid valve infective endocarditis caused by congenital heart disease,valvular disease or heart surgery,and get satisfactory results.

Key words: endocarditis, tricuspid valve, cardiovascular surgery

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[2] 刘高利 马黎明 郑善光 李祥 程前进 李庆臣 赵永亮. Ebstein心脏畸形27例外科治疗分析[J]. 临床外科杂志, 2012, 20(3): 175-175.
[3] 王杰 王志维 夏军 吴红兵 吴智勇 任伟 周桢 柳亚奎. 60岁以上老年StanfordA型主动脉夹层手术31例体会[J]. 临床外科杂志, 2012, 20(2): 123-123.
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