[感染性心内膜炎的治疗]。

La Revue du praticien Pub Date : 2024-06-01
Florent Arregle
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摘要

感染性心内膜炎的治疗。感染性心内膜炎(IE)患者由多学科团队负责治疗。治疗包括尽早开始抗生素治疗,根据致病菌进行调整并延长治疗时间,在有手术指征时配合手术治疗。肠外抗生素治疗在医院开始,至少持续两周。根据患者的病情变化,可以考虑在门诊使用抗生素治疗,如果 IE 是由最常见的病菌引起的,可以建议病情稳定的患者口服抗生素。IE 的手术治疗包括完全切除感染组织,目的是恢复瓣膜功能的完整性。在可能的情况下进行保守性手术治疗,否则将进行瓣膜置换术。识别手术适应症(心力衰竭、感染失控和预防栓塞风险)对于改善预后至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Treatment of infective endocarditis].

TREATMENT OF INFECTIVE ENDOCARDITIS. Patients with infective endocarditis (IE) are taken care for by multidisciplinary teams. The treatment consists of antibiotic therapy initiated early, adapted to the responsible germ and prolonged, associated with surgical treatment when there is an indication for surgery. A parenteral antibiotic therapy is initiated in hospital for a period of at least two weeks. Depending on evolution of the patients, outpatient antibiotic treatment may be considered, and oral antibiotics may be proposed in stable patients when IE is caused by the most frequent germs. The surgical treatment of IE consists of total excision of the infected tissues and aims to restore the integrity of valvular functions. Conservative surgical treatment is performed, when possible, otherwise valve replacement is the alternative. The recognition of surgical indications (heart failure, uncontrolled infection, and prevention of embolic risk) is essential to improve the prognosis.

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