Objective To analyze the clinical characteristics, therapeutical approaches and outcome of infective endoearditis (IE). Methods The cardiac disease background, main clinical situation, blood cultivation, echocardiography, treatment effect and prognosis of 44 cases were retrospectively analyzed. Results There were 17 cases (43.2 ％ ) with rheumatic heart diseases, 14 cases ( 31.8 ％) with congenital heart diseases and 8 cases (18.2 ％) without underlying cardiac diseases. The echocardiography results showed that vegetations were present in all cases (100％). Positive blood culture was found in 26 (59.1％). Viridans Streptococcus (12 cases, 27. 3％) was the most common organism and followed by Staphylococcus (12 cases, 27. 3 ％ ). Conclusion The proportion of cardiac disease background of IE has undergone significant diversifications. The predominant organism is still Viridans Streptococcus. Both blood culture and echocardiography have important value to diagnosis of IE and early diagnosis, aggressive medical treatment combined with appropriate surgical therapy are keys to successful management of IE.%目的 探讨分析基层医院感染性心内膜炎(IE)的临床特点、治疗方法及转归.方法 回顾性分析收治住院的44例IE患者的临床资料,包括基础心脏病情况、主要临床表现、血培养、超声心动图检查、26262治疗结果及预后等资料.结果 44例IE患者中,风湿性心脏病17例(42.2%),先天性心脏病14例(31.8%),无心脏病基础8例(18.2%).临床表现为发热44例(100%)和进行性贫血29例(65.9%).超声心动图检查发现赘生物44例.39例患者做血培养,阳性率为59.1%(26例),其中最常见为草绿色链球菌(12例,27.3%),其次为金黄色葡萄球菌(6例,13.6%).使用最多的抗生素为头孢菌素(47.7%),联合用药最多者为头孢菌素+喹诺酮类(47.0%).5例IE经单纯内科治疗死亡,病死率为11.4%(5/44).结论 IE的基础病因比例在基层医院发生明显变化,草绿色链球菌仍是主要致病菌,血培养和超声心动图检查对IE的诊断具有重要价值,早期诊断,内、外科联合是成功治疗IE的关键.
展开▼
