室缺，请指点

libeibei

<p></p><p></p><p>医生:</p><p>&nbsp;&nbsp;&nbsp;&nbsp; 您好！这是最新的检查结果，是在贵院做的，但由于一些特殊原因，正式的检查结果没给医生看（只看了手写的，当时的门诊医生建议等到明年再说）。我怕当时的结果不详细，影响医生的判断，所以，发到这里，请您给提个建议。</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;孩子目前2岁，活泼好动，发育一般。</p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">M</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">型超声心动图（厘米）</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">LVDd3.14<span style="mso-spacerun: yes;">&nbsp; </span>RVDd<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>IVSd<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>LVPWd 0.34<span style="mso-spacerun: yes;">&nbsp; </span>Ao1.33</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">LVDs2.06<span style="mso-spacerun: yes;">&nbsp; </span>RVDs<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>IVSs<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>LVPWs 1.55</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">心功能</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">LVEF 65%<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>LVFS<span style="mso-spacerun: yes;">&nbsp; </span>34%</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">二维超声</span><span lang="EN-US"><font face="Times New Roman">(</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">平方厘米</span><span lang="EN-US"><font face="Times New Roman">)</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="Times New Roman"><personname wst="on" productid="LA   LV   RA"></personname><span lang="EN-US">LA<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span><city wst="on"></city><place wst="on"></place>LV<place></place><city></city><span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>RA</span><personname></personname><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp; </span>RV<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>MRA<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>TRA</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">频谱多普勒超声</span><span lang="EN-US"><font face="Times New Roman">(</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">米</span><span lang="EN-US"><font face="Times New Roman">/</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">秒</span><span lang="EN-US"><font face="Times New Roman">)</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">AAo1.0<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>DAo1.6<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>LVOT<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp; </span>RVOT<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>MPA0.8</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">MV1.0<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>TV0.6<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">跨瓣压差</span><span lang="EN-US"><font face="Times New Roman">mmHg</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">彩色多普勒超声</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">MR</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">阴性</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>AI</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">阴性</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;">&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;</span>TR</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">轻微</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>PI</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">轻微</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">心房水平无分流</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman">&nbsp;&nbsp; </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">心室水平左向右分流</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>4</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">米</span><span lang="EN-US"><font face="Times New Roman">/</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">秒</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman">&nbsp;&nbsp; </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">大动脉水平无分流</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">超声所见</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">心脏位置及连接正常</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">左房、左室腔无明显增大，左室收缩活动可。肺动脉无明显增宽，瓣膜开放活动正常。房间隔完整。室间隔缺损（膜周流入道</span><span lang="EN-US"><font face="Times New Roman">+</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">小梁）</span><span lang="EN-US"><font face="Times New Roman">0.65</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">厘米</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">部分三尖瓣组织附着</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">分流弥散</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">分流束宽</span><span lang="EN-US"><font face="Times New Roman">0.43</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">厘米</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">左向右分流</span><span lang="EN-US"><font face="Times New Roman">4</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">米每秒</span><span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">左位主动脉弓</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">未见动脉导管开放</span><span lang="EN-US"><font face="Times New Roman">.</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="Times New Roman">&nbsp;</font></p></span></p><p><font face="Times New Roman">&nbsp;</font></p><p></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="Times New Roman">&nbsp;</font></p></span></p><p><font face="Times New Roman">&nbsp;</font></p><p></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">张玉奇</span></p>

libeibei

<p>怎么没有回复？</p>

全康复

顶一下

陆医生

估计你看的是心脏内科吧，个人意见建议及早考虑手术治疗。

全康复

<p>跟我的想法一模一样，她是看黄美蓉副主任的（内科）。</p>

libeibei

陆医生，你好！谢谢你的回复，我想问问：你是根据什么判断的？是因为2岁后自愈的可能性变小还是彩超的结果显示必须及早手术？如果等到明年，是不是对孩子的发育或者说其他方面有不利的影响？为什么外科和内科的建议会有这么大的区别？作为家长，我们应该如何（有这种想法的家长估计不止我一个）？作为医院，能不能把外科和内科协调起来，给一个比较明确的说法，让家长心理有个谱？

林妹妹

<p>怎么房缺会增大了这么多?</p>

陆医生

首先，想让内科医生和外科医生的想法一致，这种可能性不大；<br/>其次，小孩已经2岁了，缺损还有这么大，估计自愈可能性不大；<br/>内科医生的想法可以理解，如果等到3岁以后还没有自愈，那就可以介入治疗；<br/>外科医生的想法则是，及早手术治疗，可以避免发生一些不良并发症；<br/>你说谁更有道理呢？呵呵。