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目的 提高对右心感染性心内膜炎肺损害的认识。方法 通过胸片、胸部B超、血气分析、痰培养等检查手段对 1994～ 2 0 0 0年住院的 2 8例静脉应用毒品致右心感染性心内膜炎肺损害的病例进行回顾性分析。结果 肺损害占 10 0 % (2 8/ 2 8) ,咳嗽占 10 0 % (2 8/ 2 8) ,咳痰占 71% (2 0 / 2 8) ,气促占 6 4% (18/ 2 8) ,胸痛占 5 7% (16 / 2 8) ,咯血占 36 % (10 / 2 8) ,肺部音占 71% (2 0 / 2 8)。胸片 :浸润性改变占 82 % (2 3/ 2 8) ,多发性囊状影占 2 1% (6 / 2 8) ,肺栓塞占 2 1% (6 / 2 8) ,胸腔积液占 2 1% (6 / 2 8)。B超胸腔积液占 2 1% (6 / 2 8)。Ⅰ型呼吸衰竭占 14% (4 / 2 8)。痰培养阳性率 5 4% (15 / 2 8)。选用 2～ 3种抗生素治疗 4～ 6周 ,有效占 82 % (2 3/ 2 8) ,无效而手术占 18% (5 / 2 8) ,其中手术的 2例死亡 ,病死率7% (2 / 2 8)。结论 右心感染性心内膜炎肺损害在应用毒品者十分常见 ,应引起重视 ,以免误诊
Objective To improve the understanding of lung damage in right-hearted infective endocarditis. Methods A retrospective analysis was carried out on 28 cases of intravenous drug-induced lung damage from right ventricular endocarditis in 28 hospitalized patients from 1994 to 2000 through chest X-ray, chest ultrasound, blood gas analysis and sputum culture. . Results Pulmonary damage accounted for 10% (28/28), cough 10% (28/28), sputum 71% (20/28), and breathlessness 64% (18 / Chest pain was 57% (16/28), hemoptysis was 36% (10/28), and lung tone was 71% (20/28). The chest radiographs showed that infiltrative changes accounted for 82% (23/28), multiple cystic lesions were 21% (6/28), pulmonary embolism was 21% (6/28), pleural effusion accounted for 2 1% (6/2 8). B super-pleural effusion accounted for 2 1% (6/2 8). Type I respiratory failure accounted for 14% (4/28). The positive rate of sputum culture was 54% (15/28). 2 to 3 kinds of antibiotics were used for 4 to 6 weeks, 82% (2/3 / 8) of them were effective and 18% (5/28) of them were ineffective. Among them, 2 cases were killed and the case fatality rate was 7% (2 / 2 8). Conclusions Right heart infection with endocarditis lung damage is very common in the application of drugs, should pay attention to avoid misdiagnosis