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Непосредственные и отдаленные результаты хирургического лечения активного инфекционного эндокардита нативных клапанов сердца у наркозависимых пациентов

Непосредственные и отдаленные результаты хирургического лечения активного инфекционного эндокардита нативных клапанов сердца у наркозависимых пациентов

Abstract

Материал и методы. Проведено ретроспективное обсервационное исследование на базе регистра пациентов, оперированных в 2000-2010 гг. В исследование включены 107 пациентов с ИЭ, развившемся на фоне использования инъекционных наркотиков. Всем пациентам выполнено хирургическое лечение поражения клапанов сердца. Три пациента умерли после операции в стационаре и 104 выписаны. Отдаленные результаты прослежены у 73 пациентов. Результаты. Средний возраст пациентов, включенных в исследование, составил 28,6 ± 5,4 года. Первичный ИЭ нативных клапанов сердца зарегистрирован в 68,2 % случаев. Госпитальная летальность в раннем послеоперационном периоде составила 2,8 %. Среднее время наблюдения составило 6,8 ± 0,5 года. В разные сроки наблюдения погибли 27 (50,0 %) из 54 пациентов, продолжавших употреблять инъекционные наркотики, рецидив ИЭ отмечен в 25,9 % случаев (р=0,01), реоперации в 35,2 %. Среди 19 пациентов, прекративших употребление инъекционных наркотических препаратов после операции, летальных исходов, реопераций, рецидивов ИЭ не было. К трудовой деятельности после операции на сердце вернулись 11 (15,1 %) пациентов, из которых 8 (72,7 %) из группы не употреблявших наркотики в послеоперационный период и 3 (27,3 %) из группы продолжавших употреблять наркотики (р<0,0001). Заключение. Отдаленные результаты лечения ИЭ среди наркоманов зависят от продолжения или прекращения употребления наркотических препаратов.

Objective. The aim of this work is to analyze the immediate and long-term results of surgical treatment of valve infective endocarditis (IE) in drug-dependent patients. Material and methods. A retrospective observational study based on the register of patients operated in A.N. Bakoulev Center of Cardiovascular Surgery from 2000 to 2010. The study included 107 patients with IE that developed against the background of injecting drug users (32 women and 75 men). All patients underwent surgical treatment of valvular heart disease. Three patients died after surgery in hospital and 104 were discharged. Long-term results were evaluated in 73 patients. Results. The average age of the patients included in the study was 28.6 ± 5.4 years. Primary of IE native heart valves was registered in 68.2 % of cases. Hospital mortality in the early postoperative period was 2.8 %. The average time of observation was 6.8 ± 0.48 years. At different periods of observation among 54 patients who continued to inject drugs 27 (50.0 %) died, relapse of IE occurred in 25.9 % of cases (p = 0.01) and reoperation in 35.2 %. Deaths, reoperations, recurrence of IE were not observed among the 19 patients who stopped injecting narcotic drugs after surgery. Conclusion. Long-term results of IE treatment among drug addicts depend on the continuation or termination of the narcotic drug use.

Keywords

ИНФЕКЦИОННЫЙ ЭНДОКАРДИТ, ИНЪЕКЦИОННЫЕ НАРКОМАНЫ, ПРОТЕЗИРОВАННЫЙ КЛАПАН, РЕОПЕРАЦИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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