TREATMENT OF INFECTIVE ENDOCARDITIS - 10-YEAR COMPARATIVE ANALYSIS
TREATMENT OF INFECTIVE ENDOCARDITIS - 10-YEAR COMPARATIVE ANALYSIS
复制标题
DOI：
10.1161/01.cir.58.4.589
复制
发表时间：
1978-01-01
期刊：
影响因子：
37.8
通讯作者：
DISMUKES, WE
中科院分区：
文献类型：
--
作者：
RICHARDSON, JV;KARP, RB;DISMUKES, WE
分析了182例活动性感染性心内膜炎患者10年期间的手术和非手术治疗结果。心力衰竭、瓣环和心肌扩张、心脏传导阻滞和冠状动脉栓塞，最常见于葡萄球菌和真菌性心内膜炎，是自体瓣膜心内膜炎（NVE）和人工瓣膜心内膜炎（PVE）的主要死亡原因。在NVE中，手术显著提高了中、重度心力衰竭患者的生存率（P < 0.05）和所有葡萄球菌性心内膜炎患者的生存率（P < 0.03）。在PVE中，手术显著影响中度或重度心力衰竭患者的生存率（P < 0.05）和整个晚期PVE组的生存率（P < 0.01）。对于自体瓣膜心内膜炎和中度或重度心力衰竭的患者，建议早期手术;葡萄球菌NVE患者，无论血流动力学状态如何，都应接受早期瓣膜置换术。对于伴有中度或重度心力衰竭的PVE患者，建议早期手术。早期和晚期葡萄球菌PVE的早期瓣膜置换术也是推荐的。
The results of surgical and non-surgical treatment of active infective endocarditis in 182 patients over a 10-yr period were analyzed. Heart failure, annular and myocardial abscesses, heart block and coronary embolism, seen most frequently with staphylococcal and fungal endocarditis, were the primary causes of death in native value endocartidis (NVE) and prosthetic valve endocarditis (PVE). In NVE, surgery significantly improved the survival in patients with moderate or severe heart failure (P < 0.05) and in all patients with staphylococcal endocarditis (P < 0.03). In PVE, surgery significantly influenced survival in patients with moderate or severe heart failure (P < 0.05) and in the entire group with late PVE (P < 0.01). Early surgery is recommended for patients with native valve endocarditis and moderate or severe heart failure; those patients with staphylococcal NVE, regardless of hemodynamic state, should undergo early valve replacement. Early surgery is recommended for PVE patients with moderate or severe heart failure. Early valve replacement for early and late staphylococcal PVE is also recommended.