[求助]术后复查咨询

ybao 发表于 2006-8-15 23:48:45

张子阳患PS（近似PA）、ASD、TR三个多月，4月26日在贵中心胸外科由张海波医生手术，今天做彩超复查，检查结果如下：<table class="MsoNormalTable" cellspacing="0" cellpadding="0" width="492" border="1" style="BORDER-RIGHT: medium none; BORDER-TOP: medium none; MARGIN: auto auto auto 5.4pt; BORDER-LEFT: medium none; WIDTH: 369pt; BORDER-BOTTOM: medium none; BORDER-COLLAPSE: collapse; mso-border-alt: solid windowtext .5pt; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext;"><tbody><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 0; mso-yfti-firstrow: yes;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt;">主动脉根部内径    15   mm</td><td valign="top" width="72" rowspan="2" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 54pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt;">二尖瓣口峰值速度</td><td valign="top" width="156" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: windowtext 1pt solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 117pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt;">EVmax  0.99  m/s</td></tr><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 1;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">左房缩末前后径    20   mm</td><td valign="top" width="156" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 117pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">AVmax  0.80  m/s</td></tr><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 2;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">左室舒末前后径    27   mm</td><td valign="top" width="228" colspan="2" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 171pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">左室流出道峰值速度    0.79  m/s</td></tr><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 3;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">室间隔   4  mm   左室后壁    4  mm</td><td width="72" rowspan="4" style="BORDER-RIGHT: windowtext 1pt; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7 solid; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7 solid; WIDTH: 54pt; LAYOUT-FLOW: vertical-ideographic; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">左室泵血功能</td><td valign="top" width="156" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 117pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">SV       ml</td></tr><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 4;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">右室流出道17 mm 肺动脉内径12 mm</td><td valign="top" width="156" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 117pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">Co       1/min</td></tr><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 5;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">右室内径  25 mm   （横径）</td><td valign="top" width="156" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 117pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">EF       %</td></tr><tr style="HEIGHT: 25.5pt; mso-yfti-irow: 6; mso-yfti-lastrow: yes;"><td valign="top" width="264" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: windowtext 1pt solid; WIDTH: 198pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">右房长径   29 mm  短径    26 mm</td><td valign="top" width="156" style="BORDER-RIGHT: windowtext 1pt solid; PADDING-RIGHT: 5.4pt; BORDER-TOP: #f7f7f7; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0cm; BORDER-LEFT: #f7f7f7; WIDTH: 117pt; PADDING-TOP: 0cm; BORDER-BOTTOM: windowtext 1pt solid; HEIGHT: 25.5pt; BACKGROUND-COLOR: transparent; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt;">SI        ml/m2</td></tr></tbody></table>超声检查：1.主动脉及肺动脉内径正常，瓣膜不厚，活动自如。2.右心房、室内径增大（RA：29×26mm2、RV：25mm），左房、左室内径正常，右室壁厚4mm。3.室间隔及左室后壁厚度正常，室壁运动未见异常。4.二尖瓣不厚，活动自如，三尖瓣瓣尖回声稍强，开放正常，关闭欠佳。5.房间隔中部可见一4mm回声失落区，室间隔连续未见中断，另右房内可见强回声光带飘动（欧式瓣回声）。肺动脉瓣口收缩期前向血流速度Vmax：1.43m/s，pg：8mmHg，舒张期可见轻度返流Vmax：1.75m/s。三尖瓣口收缩期可见中度返流：Vmax：3.34m/s，pg：45mmHg，估测肺动脉收缩压55mmHg。房间隔中部可见左向右分流跨隔血流：Vmax：1.31m/s，pg：7mmHg。符合先心术后声像图改变（法洛式三联症）问现在我们如何护理孩子？谢谢

陆医生 发表于 2006-8-16 04:37:33

在哪里复查的超声？

ybao 发表于 2006-8-16 18:10:42

,在河南新乡第一人民医院,心电图显示心律正常，胸片显示心影稍大，肺纹理较重

陆医生 发表于 2006-8-16 20:19:48

建议术后半年在我中心复查吧。

ybao 发表于 2006-8-18 01:43:28

我与术前在新乡市第一人民医院的彩超报告做比较，三尖瓣返流有很大改善，PS已不存在，但右室、右房还显稍大，问这对心脏发育影响大吗？谢谢！

陆医生 发表于 2006-8-18 18:32:26

影响不大，心室心房增大不可能很快恢复正常的。

ybao 发表于 2006-8-22 00:37:50

请问我这孩子需要限制活动量么？哭闹影响心脏恢复么？

陆医生 发表于 2006-8-22 03:16:09

活动量还是控制一下吧，哭闹你们能控制的了么？呵呵

ybao 发表于 2006-8-22 17:28:45

能不能给孩子吃些补钙食品？孩子现在有18斤重，70cm高，长的有点快。谢谢！

陆医生 发表于 2006-8-22 23:47:12

可以。

ybao 发表于 2006-8-25 23:41:37

你好!经过一段学习,我想问一些专业问题1是么是继发性房缺?有自愈可能么?2三尖辬返流是什么原因造成的?3心室.心房扩大多长时间才能恢复?恢复正常了三尖瓣返流是否就正常了?4肺动脉高压后果是什么?5手术时张海波主任说作了右向左分流,这样作目的是什么?谢谢!

陆医生 发表于 2006-8-28 01:07:24

晕倒，这些问题回答起来需要些篇幅了，我想也不是一句两句能说清楚的，我们近期会出版一本《先心病100问》，应该可以回答你的问题。

ybao 发表于 2006-8-29 02:09:58

哪里能买得到这本书？

陆医生 发表于 2006-8-29 20:28:41

还没有出版，呵呵

ybao 发表于 2006-9-27 23:21:50

你好！   我孩子4月26日在贵院由张海波主任主刀手术，半年复查期快到了，请问我们去复查时能不能挂特需门诊？是不是谁做的手术复查时挂谁的门诊比较好？

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上海儿童医学中心 心脏中心's Archiver

[求助]术后复查咨询

上海儿童医学中心心脏中心's Archiver