主动脉瓣纤维样赘生物的诊断及治疗

Diagnosis and Treatment of Lambl's Excrescence on Aortic Valve

目的总结主动脉瓣纤维样赘生物（Lambl’Sexcrescence，LE）的诊断及治疗经验。方法回顾性分析解放军总医院2010年1月～2012年12月收治的25例LE患者的临床资料，其中，男性17例，女性8例，患者年龄30～70岁，平均年龄55．7±11．43岁，合并脑梗死病史8例。所有患者均经食管超声心动图（TEE）检查确诊，有7例进行外科手术清除主动脉瓣赘生物。结果25例患者均治愈出院，7例手术患者无并发症及手术死亡发生，22例患者经随访0．5～3．0年无新发脑血管事件。结论多数LE患者无症状，部分患者表现为反复的脑梗死。推荐TEE作为确诊该病的主要方法。发生两次以上栓塞事件者及合并其他心脏病变需手术者推荐手术治疗清除赘生物，其他患者抗凝治疗或者观察。

Objective To summarize our experiences of diagnosis and treatment of Lambl＇s excrescence （LE） on aortic valve. Methods Clinical data of 25 patients with LE admitted to Chinese PLA General Hospital from January 2010 to December 2012 was retro- spectively analyzed. There were 17 males and 8 females with the mean age 55.7 ＋ 11.43 years （ranging from 30 to 70 years）. Among them, 8 patients were combined cerebral embolism. All patients were diagnosed by transesophageal echoeardiography （TEE）. In 7 cases,surgical treatment was suceessfully perfbrmed to remove the excrescences. Results All 25 patients were cured and discharged. There were no complications and operative mortality in 7 patients underwent surgical treatment. Twenty - two patients were followed up for 0.5 - 3.0 years without new cerehrovascular accident （ CVA）. Conclusion Most patients with LE are asymptomatie. Some patients showed re- peated episodes of stroke. We recommend TEE as the main diagnostic means of the disease. Patients who have LE and have experienced 2 or more CVAs or combined other heart disease need open heart surgery should be offered surgical excision of the excrescences. Other pa- tients should be treated conservatively with anticoagulation or monitored closely.