李岩,S.BERTRAND,Than.DOCO LECOMPTE,C.SUTY SELTON,JP.VILLEMOT

• 1:北京大学第一医院心脏外科
• 2:法国南锡大学医学院Brabois医院心血管外科
• 3:法国南锡大学医学院Brabois医院心血管外科
• 4:法国南锡大学医学院Brabois医院心血管外科

摘要(Abstract)：

目的　介绍 15例起搏器心内膜炎外科治疗的临床经验 ,讨论手术指征和时机。方法　1993年至 2 0 0 1年间 ,我们为 15例起搏器心内膜炎患者 ,施行了体外循环直视下心内起搏电极撤除术。本文对这些病人的临床资料进行回顾性研究。结果　本组病例中 ,有 2例院内死亡 ,术后随访期内 (中间值 =31 3个月 ;区间 ,1 8～ 5 8 7个月 )无远期死亡 ,总死亡率为 13 3%。所有出院病人均无感染复发。大部分病人心功能明显改善 (P <0 0 1)。只有 6例患者术后因持续存在的心律失常需要重新安装起搏器。本组病例中常见的外科手术指征为 :1)附着于起搏电极的大型赘生物 ,2 )顽固感染 ,3)三尖瓣架构损坏 ,4)肺栓塞 ,5 )存在需要外科处理的基础的或并存的心脏病变。结论　根据我们的结果及相关文献报道 ,我们认为对患起搏器心内膜炎的病人 ,应尽早采用外科手术撤除植入的心内起搏器硬件。手术治疗的远期效果是值得信赖的。

关键词(KeyWords)： 感染性心内膜炎;起搏器并发症;外科手术指征

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李岩,S.BERTRAND,Than.DOCO LECOMPTE,C.SUTY SELTON,JP.VILLEMOT

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