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目的:探讨马方综合征并发感染性心内膜炎的外科治疗的体会。方法:回顾性分析2009年7月至2012年12月我院30例马方综合征并发感染性心内膜炎患者,男19例,女11例,年龄23-58(41.6±15.2)岁,所有患者均进行了抗生素治疗和心瓣膜置换或成形术,其中对患者进行经典Bentall手术12例,纽扣法Bentall手术18例,比较分析手术治疗马方综合征并发感染性心内膜炎疗效。结果:手术时间276-742(405.0±125.0)min,体外循环时间115-319(159.0±43.0)min,机械通气辅助时间1～12(2.4±2.0)d,住院时间10-60(28.5±11.0)d,术后出现并发症有7例,经二期手术治愈有5例,2例抢救无效死亡,并发症发生率为23.3%,死亡率为6.7%。结论:对于马方综合征并发感染性心内膜炎患者,正确把握手术的时机和抗感染药物治疗剂量,积极采取外科手术治疗是最佳的治疗方法。
Objective: To investigate the surgical treatment of Marfan syndrome complicated with infective endocarditis. Methods: From July 2009 to December 2012, 30 patients with Marfan syndrome complicated with infective endocarditis were retrospectively analyzed. There were 19 males and 11 females, aged 23-58 (41.6 ± 15.2 years) All patients were treated with antibiotics and heart valve replacement or angioplasty, including 12 cases of patients with classic Bentall surgery, button Bentall surgery in 18 cases, comparative analysis of the treatment of Marfan syndrome complicated with infective endocarditis. Results: The operative time was 276-742 (405.0 ± 125.0) min, the CPR time was 115-319 (159.0 ± 43.0) min, the duration of mechanical ventilation was 12-12 (2.4 ± 2.0) d, the length of stay was 10-60 (28.5 ± 11.0) ) d, there were 7 cases of postoperative complications, 5 cases were cured by the second surgery, 2 cases died of rescue, the complication rate was 23.3%, the mortality rate was 6.7%. Conclusion: For patients with Marfan syndrome complicated with infective endocarditis, to correctly grasp the timing of surgery and anti-infective drug dosage, and actively take surgical treatment is the best treatment.