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yxfbbiedtj · Wysłany: Nie 16:02, 06 Mar 2011

Infective endocarditis clinical analysis of 107 cases

Teachers and ventricular septal defect-free 168% fan base the most heart disease. The earliest clinical features of fever of unknown origin showed 100 cases, accounting for 935%; in the latter part of 101 patients with different degrees of anemia, accounting for 94.4%; the early emergence of a new murmur in 17 cases, accounting for 15.9% of the original noise intensity change 40 cases, accounting for 37.3%, occurred in the late; skin revolves membrane bleeding in 37 cases, 34.6%, more common in subacute IE, the course is longer; the phenomenon of 40 cases of thrombosis, accounting for 37.4% Among them, brain, kidney embolism based, common in the late course of the disease, 3 cases of cerebral embolism in early death. 18 cases of death in 10 cases with cerebral embolism, therefore, cerebral embolism based the most serious complications of disease, attention should be paid. Echocardiography found 96 cases of cardiac neoplasm, accounting for 89.7%, for the rapid and effective means of diagnosis of the disease. Changes in pathogens has long Streptococcus viridans is the main pathogens of infective endocarditis, especially in the use of antibiotics prior to about 9o% ~ 95%, although in recent years, dropped to 49% to 69% ... but still is the major pathogenic bacteria, this group accounted for 29.1%. 14 down blood culture growth of Staphylococcus aureus, representing 255%, of which 10 were acute IE, 7 patients without structural heart disease, 2 cases of valve replacement surgery and cured, 2 died down. In the absence of structural heart disease in violation of parts of the Staphylococcus aureus tricuspid valve 3 down, 2 cases of aortic valve, mitral valve 1 down, left 1 down. Treatment change 1. Drugs: early use of antibiotics can significantly reduce the morbidity and mortality, is one of the keys to successful treatment. Bactericidal drugs generally used in blood culture results are not achieved by prior experience is still given antibiotics for Streptococcus viridans, bacteria can also be pathways, choice of antibiotics in patients with clinical manifestations. The group of more preferred to penicillin, if allergic to penicillin or cephalosporin puzzle selection with aminoglycosides or cephalosporins combined with chloroquine Well ketone to obtain blood culture report, and then adjust the medication according to drug sensitivity. You can enter non-specific k, OAmt, is expected to achieve better results. r> Internal Intensive Medicine Volume 6,[link widoczny dla zalogowanych], No. 3 based on Table 1, anemia, splenomegaly and skin and mucous fever heart disease petechia brain + kidney lung,[link widoczny dla zalogowanych], brain and kidney the other the emergence of new changes in the existing noise of the noise intensity in patients with the acute onset of acute IE, short duration, no other blood culture results, to a large number of combination of antibiotics, resulting in positive blood cultures in this group was not high (5l, 4%). Staphylococcus aureus positive for this group of 14 cases, 2 deaths, 2 cases of valve replacement surgery, conservative treatment cure rate 71,4%, with vancomycin and vancomycin to a wide range of applications and the appropriate timing of surgery choice, the cure rate of S. aureus IE is also slightly higher than reported in Western literature (60% to 70%) 』. 2. Surgery: If the poor drug efficacy, that is difficult to enter the vegetation of antibiotics to kill bacteria, or bacteria were not sensitive to antibiotics; valves (artificial or natural flap flap) of the fungal infection; vegetation so the lOHm; are myocardial abscess; treatment of 48 ~ 72h invalid; hemodynamic disorders are difficult to control, as soon as possible surgery. 3O surgery in this group, acute 1E33 12 cases of surgical cases, 36%; subacute IE74 cases, surgery l8 cases, accounting for 24%. 30 cases of surgical procedures: aortic valve replacement in 9 cases, 8 cases of mitral valve replacement. Double valve replacement in 2 cases, 5 cases of ventricular septal defect repair, ventricular septal defect repair + aortic valve replacement in 2 cases, ventricular septal defect repair patch + 2 cases of pulmonary arterial catheter suture in 2 cases. L cases in which double valve replacement surgery because of reflux around the mitral annulus, leading to recurrent endocarditis, Staphylococcus epidermidis growth; the other 1 case occurred after aortic valve replacement valve abscess,[link widoczny dla zalogowanych], the growth of Staphylococcus aureus by a large number of antibiotic treatment improved. Therefore,[link widoczny dla zalogowanych], surgery requires complete removal of diseased tissue and the infection focus, giving a good myocardial protection, full correction of cardiac malformation. 1 case of ventricular septal defect after repair of pulmonary artery patch + 1d death, 29 cases were cured,[link widoczny dla zalogowanych], the cure rate of 96,7%. The conservative treatment of 77 patients died l7 cases, 6 cases were cured, the cure rate 70.1%. Reference prince Yu Chen Wen cut l taboo. Gao Er cable, the main matched them. Studies of modern heart baby Ranke Changsha: Hunan Science and Technology Press material. 19937372Kuet ~ lerWInIekt; oEndolmrdifis} rz, 1999.24 (4): 31.3 coffee Graeveni ~, A. Mik ~ NologleIn: K, ed. 1n {ek ~ En-dokarditis; 2AufIaDarmstadt: ~ elnkopff, 1994.54 (1999-11-29 Received 2000.03-14 repair field)