CAJ | 학술논문

目的探讨早期手术治疗感染性心内膜炎(IE)的可行性.方法 1996年6月至2011年7月,135例IE患者接受手术治疗.分为A组(早期手术治疗组,2008年后收治的患者)和B组(传统治疗组,2008年前收治的患者).比较两组患者死亡、治疗后心功能不全、感染复发、出院后栓塞等事件,分析患者生存情况.结果两组患者一般资料无差异.组间比较,A组患者整体死亡比例下降(9.4％对23.0％,P=0.016);心脏功能衰竭患者比例减少(5.4％对26.2％,P＜0.001);两组患者感染复发比例无差异(0对4.9％,P=0.112;).A组患者手术比例高(67.6％对32.8％,P＜0.001),手术死亡率及再感染发生率未增加(6.0％对15.0％,P=0.222;0对5.0％,P=0.405).结论早期积极合理的外科治疗可以改善IE患者整体预后.
목적 탐토조기수술치료감염성심내막염(IE)적가행성.방법 1996년6월지2011년7월,135례IE환자접수수술치료.분위A조(조기수술치료조,2008년후수치적환자)화B조(전통치료조,2008년전수치적환자).비교량조환자사망、치료후심공능불전、감염복발、출원후전새등사건,분석환자생존정황.결과 량조환자일반자료무차이.조간비교,A조환자정체사망비례하강(9.4％대23.0％,P=0.016);심장공능쇠갈환자비례감소(5.4％대26.2％,P＜0.001);량조환자감염복발비례무차이(0대4.9％,P=0.112;).A조환자수술비례고(67.6％대32.8％,P＜0.001),수술사망솔급재감염발생솔미증가(6.0％대15.0％,P=0.222;0대5.0％,P=0.405).결론 조기적겁합리적외과치료가이개선IE환자정체예후.
Objective The surgery time for patients with infective endocarditis (IE) has been transformed.It has been supported that,for the patients with surgical indications,the surgery time should be as early as possible to improve the clinical outcome.The purpose of the research is to identify whether the patients with IE could get further benefit from early surgery.Methods Between June 1996 and July 2011,135 IE patients'data has been collected retrospectively,all of whom were verified through the modified Duke categories.The patients were devided into group A( the new therapeutic schedule group after 2008 ) and group B( the traditional therapeutic schedule group before 2008 ) by the year of 2008.The end points of observation were death associated with IE,cardiac failure,embolism,and re-infection.The comparison between the groups was by means of non-parameter rank and inspection test,variance analysis,t test,chi-square test,fisher exact test.The outcome comparison between the groups was via the Kaplan-Meier survival analysis.Results There were no significant differences in baseline data between the groups.No survival differences could be observed via the Kaplan-Meier analysis( Log Rank P =0.189).During the following-up visit,compared with the patients in group B,the mortality in group A is lower(9.4％ vs.23.0％,P=0.016),the incidence of heart failu re was less in group A (5.4％ vs.26.2％,P ＜0.001 ).No differences could be found in re-infection between the two groups(0 vs.4.9％,P =0.112 ). More patients in group A underwent surgery (67.6％ vs.32.8％,P ＜0.001 ).Conclusion The new therapeutic sehedule of IE coull reduce the mortality rate and promote the cardiae funetion.The incidence of re-infeetion didn't increase.