<P><FONT size=3>家不在上海,女儿两岁半,体重28斤,经检查先天性心脏病。平时无明显症状。目前感冒咳嗽。 </FONT>
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<P><FONT size=3>彩超报告单: </FONT> f% Y; k( g2 @
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6 V# n9 r ?) G& Y. n7 j0 F' v<P><FONT size=3>主要测值(括号内为成人正常参考值):</FONT></P>
- I6 w0 f6 J. o( I+ s. U<P><FONT size=3>主动脉根部内径:<FONT face="Times New Roman">14</FONT>(<FONT face="Times New Roman">20</FONT>-<FONT face="Times New Roman">37mm</FONT>) 左房内径:<FONT face="Times New Roman">29</FONT>(<FONT face="Times New Roman">19</FONT>-<FONT face="Times New Roman">40mm</FONT>)</FONT></P># q% W8 |! r9 O( V% q8 y
<P><FONT size=3>左室舒末径:<FONT face="Times New Roman">32</FONT>(<FONT face="Times New Roman">35</FONT>-<FONT face="Times New Roman">55mm</FONT>) 左室缩末径:<FONT face="Times New Roman">17</FONT>(<FONT face="Times New Roman">25</FONT>-<FONT face="Times New Roman">35mm</FONT>)</FONT></P>3 Y. w' K7 J, @% Q! R3 u
<P><FONT size=3>室间隔厚:<FONT face="Times New Roman">6</FONT>-<FONT face="Times New Roman">7</FONT>(<FONT face="Times New Roman">6</FONT>-<FONT face="Times New Roman">11mm</FONT>)<FONT face="Times New Roman"> </FONT>左室后壁厚:<FONT face="Times New Roman">6</FONT>(<FONT face="Times New Roman">6</FONT>-<FONT face="Times New Roman">11mm</FONT>)</FONT></P>6 [9 a O" w; H6 d; g
<P><FONT size=3>右室内径:<FONT face="Times New Roman">31</FONT>(<<FONT face="Times New Roman">20mm</FONT>) 右室横径:<FONT face="Times New Roman">35mm </FONT> 右房横径:<FONT face="Times New Roman">35mm</FONT></FONT></P>, l5 N$ U$ {* ` X0 n
<P><FONT size=3>主肺动脉内径:<FONT face="Times New Roman">23</FONT>(<<FONT face="Times New Roman">26mm</FONT>) 右室流出道:<FONT face="Times New Roman">20</FONT>(<FONT face="Times New Roman">20</FONT>-<FONT face="Times New Roman">30mm</FONT>) <FONT face="Times New Roman"> E</FONT>/<FONT face="Times New Roman">A</FONT>><FONT face="Times New Roman">1</FONT></FONT></P>
2 Q; l" X2 {3 X6 V" ~6 u<P><FONT size=3>描述:</FONT></P>
5 e5 V _, g4 H% o<P><FONT size=3><FONT face="Times New Roman">1</FONT>、按比例右房室增大,左房室大小正常,室壁厚度正常,静息状态下收缩运动有力,未见节段性异常。心包腔内未探及液性暗区。</FONT></P>: x1 a5 y4 b" {
<P><FONT size=3><FONT face="Times New Roman">2</FONT>、四腔心切面观:十字交叉消失,房间隔下段连续中断,回声脱失约<FONT face="Times New Roman">20</FONT>×<FONT face="Times New Roman">14mm</FONT>,房间隔上残端<FONT face="Times New Roman">25mm</FONT>。房水平可见红色为主的五彩过隔左向右分流束及左右心房血流交叉进入左右心室,房水平分流速度<FONT face="Times New Roman">1.3</FONT>/<FONT face="Times New Roman">s</FONT>,压差<FONT face="Times New Roman">6.7mmHg</FONT>。室间隔上段似见连续中断,回声脱失约<FONT face="Times New Roman">3</FONT>×<FONT face="Times New Roman">4mm</FONT>,室水平似见少量红色为主的五彩过隔左向右分流束,速度<FONT face="Times New Roman">4.9</FONT>/<FONT face="Times New Roman">s</FONT>,压差<FONT face="Times New Roman">98mmHg</FONT>。十字交叉处可见共同房室瓣,二尖瓣前瓣及三尖瓣隔瓣可见裂隙,<FONT face="Times New Roman">CDFI</FONT>示收缩期二尖瓣前瓣瓣体处可见五彩返流束至左房中部,速度<FONT face="Times New Roman">4.7</FONT>/<FONT face="Times New Roman">s</FONT>,压差<FONT face="Times New Roman">88mmHg</FONT>,瞬时返流量为<FONT face="Times New Roman">2.8ml</FONT>;收缩期三尖瓣隔瓣瓣体处可见五彩返流束至右房中部,速度<FONT face="Times New Roman">3.1</FONT>/<FONT face="Times New Roman">s</FONT>,压差<FONT face="Times New Roman">36mmHg</FONT>,瞬时返流量为<FONT face="Times New Roman">1.7ml</FONT>。主动脉瓣及肺动脉瓣形态结构正常,启闭运动好,未见异常血流。二尖瓣血流图示<FONT face="Times New Roman">E</FONT>峰大于<FONT face="Times New Roman">A</FONT>峰。</FONT></P>0 ` }- K# t- A
<P><FONT size=3><FONT face="Times New Roman">3</FONT>、主动脉不宽,肺动脉主干及分支增宽,其左右分支内径均为<FONT face="Times New Roman">11mm</FONT>,其内血流信号未见异常。据三尖瓣返流压差估测肺动脉压为<FONT face="Times New Roman">51 mmHg</FONT>。</FONT></P>8 W/ ?5 N% @% a) @9 W
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<P><FONT size=3>超声诊断:</FONT></P>1 e0 y, d$ u3 G" {4 n7 y3 U
<P><FONT size=3>先天性心脏病:</FONT></P># O2 F' c; t7 H+ s
<P><FONT size=3><FONT face="Times New Roman">1、 </FONT>房间隔缺损(原发孔型),房水平以左向右分流为主。</FONT></P>$ z* t2 w: E; ?' G) L$ |( O
<P><FONT size=3><FONT face="Times New Roman">2、 </FONT>室间隔小缺损(膜周型)可能,室水平左向右分流。建议术中仔细探查。</FONT></P>
* {; A$ A& r! c<P><FONT size=3><FONT face="Times New Roman">3、 </FONT>二尖瓣前瓣+三尖瓣隔瓣裂并轻度关闭不全。</FONT></P>! F0 L. {7 B" U8 `4 \) ?
<P><FONT size=3><FONT face="Times New Roman">4、 </FONT>中度肺动脉高压。</FONT></P>+ a" a' |+ F3 M+ j# V
<P><FONT size=3>考虑心内膜垫缺损(过渡型)可能性大。</FONT></P>
复杂先心较严重,自治区医院无把握,建议去中心手术,是否需尽快?手术难度?费用?如何预约?
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