外科治疗的活动期感染性心内膜炎患者短期生存率与复发率分析
摘要
目的探讨外科治疗对活动期感染性心内膜炎(active infective endocarditis,AIE)患者的短期生存率与复发率的影响。方法回顾性分析94例AIE患者的临床资料,分析患者的血培养阳性率、生存率、复发率,比较治愈出院和死亡患者的各项相关指标。结果 94例患者中,血培养阳性率为76.60%。9例患者死于术前,术后30天85例患者中的生存率为90.48%(77/85)。此外,心内膜炎的复发率为3.90%。治愈出院和院内死亡患者的心率(左心室射血分数、白细胞总数、肌酐组间比较的差异均具有统计学意义(均P<0.05)。结论 AIE患者围术期合理应用抗生素抗感染治疗,掌握合适的外科治疗时机可明显提高其短期生存率,降低术后病死率与复发率。
引文
[1]周朝元,付庆林,段长恩,等.手术治疗先天性心脏病患者活动期心内膜炎的相关因素[J].现代生物医学进展,2016,16(7):1333-1336,1393.
[2]徐荣建,苗齐,刘兴荣,等.活动期感染性心内膜炎病原菌构成、药敏分析及早期外科治疗62例[J].中华胸心血管外科杂志,2015,31(5):278-281.
[3]Omoto T,Aoki A,Maruta K,et al.Surgical outcome in hemodialysis patients with active-phase infective endocarditis[J].Ann Thorac Cardiovasc Surg,2016,22(3):181-185.
[4]Konishi Y,Sakon Y,Nakamura K,et al.Pulmonary valvuloplasty by autologous pericardium in a patient with active infectious endocarditis and Osler's Disease[J].J Heart Valve Dis,2015,24(3):383-385.
[5]樊纪丹,杨岷.急性感染性心内膜炎外科手术治疗34例临床观察[J].中国医师进修杂志,2013,36(14):59-61.
[6]何胜平,陈雅华,张振,等.感染性心内膜炎112例临床分析[J].南方医科大学学报,2013,33(2):279-281.
[7]Kuznetsova LM,Sandrikov VA,Ivanov VA,et al.Infective endocarditis:Problems of diagnosis and treatment[J].Kardiologiia,2016,56(1):34-40.
[8]Kim JB,Ejiofor JI,Yammine M,et al.Surgical outcomes of infective endocarditis among intravenous drug users[J].J Thorac Cardiovasc Surg,2016,152(3):832-841.
[9]张建华,李辉,赵慧英,等.慢性心力衰竭伴多重耐药菌感染的临床观察[J].心脑血管病防治,2016,16(2):101-103.
[10]罗建,楼炳恒,张伟文,等.连续心排量监测技术在感染性休克早期治疗中的应用[J].心脑血管病防治,2012,12(4):278-280.
[11]Okita Y,Minakata K,Yasuno S,et al.Optimal timing of surgery for active infective endocarditis with cerebral complications:a Japanese multicentre study[J].Eur J Cardiothorac Surg,2016,50(2):374-382.
[12]Leroy O,Georges H,Devos P,et al.Infective endocarditis requiring ICU admission:epidemiology and prognosis[J].Ann Intensive Care,2015,5(1):45.
[13]邱梅红,陈冬梅,刘朝曦,等.感染性心内膜炎患者血培养阳性病原菌分布及耐药性分析[J].中国老年学杂志,2014,34(5):1215-1217.
[14]Madeira S,Rodrigues R,Tralh2o A,et al.Assessment of perioperative mortality risk in patients with infective endocarditis undergoing cardiac surgery:performance of the Euro SCORE I and II logistic models[J].Interact Cardiovasc Thorac Surg,2016,22(2):141-148.
[15]张健瑜,杨超,梁茜,等.79例感染性心内膜炎临床分析[J].中华医院感染学杂志,2013,23(9):2045-2047.
[16]Sakamoto T,Kano H,Miyahara S,et al.Efficacy of nafamostat mesilate as anticoagulation during cardiopulmonary bypass for early surgery in patients with active infective endocarditis complicated by stroke[J].J Heart Valve Dis,2014,23(6):744-751.
[2]徐荣建,苗齐,刘兴荣,等.活动期感染性心内膜炎病原菌构成、药敏分析及早期外科治疗62例[J].中华胸心血管外科杂志,2015,31(5):278-281.
[3]Omoto T,Aoki A,Maruta K,et al.Surgical outcome in hemodialysis patients with active-phase infective endocarditis[J].Ann Thorac Cardiovasc Surg,2016,22(3):181-185.
[4]Konishi Y,Sakon Y,Nakamura K,et al.Pulmonary valvuloplasty by autologous pericardium in a patient with active infectious endocarditis and Osler's Disease[J].J Heart Valve Dis,2015,24(3):383-385.
[5]樊纪丹,杨岷.急性感染性心内膜炎外科手术治疗34例临床观察[J].中国医师进修杂志,2013,36(14):59-61.
[6]何胜平,陈雅华,张振,等.感染性心内膜炎112例临床分析[J].南方医科大学学报,2013,33(2):279-281.
[7]Kuznetsova LM,Sandrikov VA,Ivanov VA,et al.Infective endocarditis:Problems of diagnosis and treatment[J].Kardiologiia,2016,56(1):34-40.
[8]Kim JB,Ejiofor JI,Yammine M,et al.Surgical outcomes of infective endocarditis among intravenous drug users[J].J Thorac Cardiovasc Surg,2016,152(3):832-841.
[9]张建华,李辉,赵慧英,等.慢性心力衰竭伴多重耐药菌感染的临床观察[J].心脑血管病防治,2016,16(2):101-103.
[10]罗建,楼炳恒,张伟文,等.连续心排量监测技术在感染性休克早期治疗中的应用[J].心脑血管病防治,2012,12(4):278-280.
[11]Okita Y,Minakata K,Yasuno S,et al.Optimal timing of surgery for active infective endocarditis with cerebral complications:a Japanese multicentre study[J].Eur J Cardiothorac Surg,2016,50(2):374-382.
[12]Leroy O,Georges H,Devos P,et al.Infective endocarditis requiring ICU admission:epidemiology and prognosis[J].Ann Intensive Care,2015,5(1):45.
[13]邱梅红,陈冬梅,刘朝曦,等.感染性心内膜炎患者血培养阳性病原菌分布及耐药性分析[J].中国老年学杂志,2014,34(5):1215-1217.
[14]Madeira S,Rodrigues R,Tralh2o A,et al.Assessment of perioperative mortality risk in patients with infective endocarditis undergoing cardiac surgery:performance of the Euro SCORE I and II logistic models[J].Interact Cardiovasc Thorac Surg,2016,22(2):141-148.
[15]张健瑜,杨超,梁茜,等.79例感染性心内膜炎临床分析[J].中华医院感染学杂志,2013,23(9):2045-2047.
[16]Sakamoto T,Kano H,Miyahara S,et al.Efficacy of nafamostat mesilate as anticoagulation during cardiopulmonary bypass for early surgery in patients with active infective endocarditis complicated by stroke[J].J Heart Valve Dis,2014,23(6):744-751.
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