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目的探讨儿童感染性心内膜炎的临床特点及影响疗效的因素。方法回顾性研究2013年11月至2015年11月上海儿童医学中心心内科诊断并治疗的33例感染性心内膜炎患儿的临床资料,分析其病原学特点、心脏基础疾病、赘生物分布特点、治疗方案及预后情况。结果感染性心内膜炎病原菌的检出率为75.76%。具有先天性心脏基础疾病的比例为93.94%。赘生物主要位于反流的瓣膜,占63.64%,其次为植入的人工材料、缺损处分流及血流冲击处等。手术结合足疗程的抗感染治疗效果较好。结论感染性心内膜炎的血培养阳性率高,且多发生于具有心脏基础疾病的患儿。早期彻底的手术治疗联合全程抗感染治疗是治疗感染性心内膜炎的关键。
Objective To investigate the clinical characteristics of children with infective endocarditis and the factors that affect the efficacy. Methods The clinical data of 33 cases of infective endocarditis diagnosed and treated in Department of Cardiology, Shanghai Children’s Medical Center from November 2013 to November 2015 were retrospectively analyzed. The etiological characteristics, cardiac disease, neoplasm distribution Characteristics, treatment options and prognosis. Results The detection rate of pathogenic bacteria of infective endocarditis was 75.76%. The proportion of patients with congenital heart diseases was 93.94%. Neoplasms mainly located in the valve of reflux, accounting for 63.64%, followed by the implantation of artificial materials, defect flow and blood flow impact at the Department. Surgery combined with full course of anti-infective treatment is better. Conclusions The positive rate of blood culture of infective endocarditis is high, and occurs mostly in children with underlying heart diseases. Early radical surgery combined with full anti-infective treatment is the key to the treatment of infective endocarditis.