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[心脏瓣膜置换术后心内膜炎的外科治疗]

[Surgical treatment of endocarditis following heart valve prosthesis].

作者信息

Tsukerman G I, Kosach G A, Malashenkov A I, Iaroshinskiĭ Iu N, Narsiia B E

出版信息

Grud Serdechnososudistaia Khir. 1990(2):14-9.

PMID:2354065
Abstract

Experience of many years in surgical treatment of prosthetic valve endocarditis (RVE) is analyzed. Patients whose condition was serious were operated on for a second time: 91.6% had preoperative functional class IV, in half of them circulatory disorders were of stage IIB--III; 62.4% were subjected to reoperation for emergency indications. Twenty-five reoperations were performed for early PVE with 52% hospital mortality, 23 reoperations-for late term PVE with mortality of 30.4%. The most frequent cause of PVE was staphylococcal infection which showed a tendency to increase in the recent years. In early PVE the severity of the condition in the recent years. In early PVE the severity of the condition was due to sepsis and intoxication, in late-term PVE it was caused by disorders of hemodynamics which were usually induced by dysfunction of the prosthesis. The results of surgical management of PVE depended on the severity of the patient's condition before the operation, timely performance of the operation, and the efficacy of antibacterial therapy.

摘要

分析了多年来人工瓣膜心内膜炎(RVE)外科治疗的经验。病情严重的患者接受了二次手术:91.6%的患者术前心功能分级为IV级,其中一半患者循环系统障碍处于IIB - III期;62.4%的患者因急诊指征接受再次手术。25例因早期人工瓣膜心内膜炎(PVE)进行再次手术,医院死亡率为52%,23例因晚期PVE进行再次手术,死亡率为30.4%。PVE最常见的病因是葡萄球菌感染,近年来有增加的趋势。在早期PVE中,近年来病情的严重程度。在早期PVE中,病情的严重程度是由于败血症和中毒,在晚期PVE中,是由通常由人工瓣膜功能障碍引起的血流动力学紊乱所致。PVE手术治疗的结果取决于手术前患者病情的严重程度、手术的及时进行以及抗菌治疗的效果。

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