|
|
<P align=center><B ><FONT size=3>患儿今年四岁，两年前查出患有先天性主动脉狭窄，现在服用地高辛和利尿剂治疗。<p></p></FONT></B></P>3 y x3 N$ ] O
<P align=center><B ><FONT size=3>中国医学科学院阜外心血管病医院<p></p></FONT></B></P>0 z& M0 _* s- D F' Y: @
<P align=center><FONT size=3><B ><FONT face="Times New Roman">EBCT</FONT></B><B >诊断报告<p></p></B></FONT></P>
. Y9 Y Z) j+ n5 ~<P ><FONT size=3>检查日期：<st1:chsdate w:st="on" IsROCDate="False" IsLunarDate="False" Day="15" Month="8" Year="2002"><FONT face="Times New Roman">2002</FONT>年<FONT face="Times New Roman">8</FONT>月<FONT face="Times New Roman">15</FONT>日</st1:chsdate><FONT face="Times New Roman"> </FONT></FONT></P>8 z7 E) _% x3 |
<P ><FONT size=3>扫描所见：</FONT></P>: K- t0 d& p6 s- g7 c6 x1 ^- Z: Y
<P ><FONT size=3>心房正位，心室右袢，房室连接关系正常。左心房室明显增大，以左室为著。</FONT></P>' }0 [. s' A5 O$ J0 N
<P ><FONT size=3>大动脉起源及位置关系正常。主动脉弓横部较细小（径约<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="8.4" UnitName="mm"><FONT face="Times New Roman">8.4mm</FONT></st1:chmetcnv>），降主动脉起始部可见一局限性的狭窄，最窄处径约<FONT face="Times New Roman">5</FONT>×<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="9" UnitName="mm"><FONT face="Times New Roman">9mm</FONT></st1:chmetcnv>，且腔内密度明显不均。可见明显的狭窄后扩张。升主动脉径约<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="12" UnitName="mm"><FONT face="Times New Roman">12mm</FONT></st1:chmetcnv>。肺动脉显影良好，测主肺动脉径约<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="20" UnitName="mm"><FONT face="Times New Roman">20mm</FONT></st1:chmetcnv>，左肺动脉径约<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="8" UnitName="mm"><FONT face="Times New Roman">8mm</FONT></st1:chmetcnv>，右肺动脉径约<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="9" UnitName="mm"><FONT face="Times New Roman">9mm</FONT></st1:chmetcnv>。</FONT></P>
: O1 s, U4 }& c X+ ]8 ~( W; L0 X<P ><FONT size=3>诊断：</FONT></P>; s a" d, R' z9 T2 _6 D* u* B
<P ><FONT size=3>先天性心脏病：</FONT></P>
, {7 ~6 a c5 h$ Q# Y- N<P ><FONT face="Times New Roman"><FONT size=3>1.</FONT> </FONT><FONT size=3>主动脉缩窄；</FONT></P>& J7 K# D0 ?- C' f& _& @
<P ><FONT face="Times New Roman"><FONT size=3>2.</FONT> </FONT><FONT size=3>左心房、室明显增大，结合临床提示有二尖瓣病变并存（关闭不全）。</FONT></P>
' R7 `: P( q* d* C0 B4 m# n' L<P align=center><B ><FONT size=3>北京市心肺血管医疗研究中心<p></p></FONT></B></P>
# O" a& \! ]4 Y. D% C6 j<P align=center><B ><FONT size=3>超声心动图示波报告<p></p></FONT></B></P>
6 j- O, U4 q, x/ _3 m- v<P ><FONT size=3>检查日期：<st1:chsdate w:st="on" IsROCDate="False" IsLunarDate="False" Day="12" Month="8" Year="2002"><FONT face="Times New Roman">2002</FONT>年<FONT face="Times New Roman">8</FONT>月<FONT face="Times New Roman">12</FONT>日</st1:chsdate></FONT></P>
# s e4 a3 B" q7 l# U& i! a<P ><FONT size=3>阳性所见：</FONT></P>: ?9 ^* N3 k8 P6 n& t8 |
<P ><FONT size=3><FONT face="Times New Roman">1 </FONT>左心增大，以右室为重，室壁厚度正常，运动减低；</FONT></P>8 h8 l: U g$ k/ v
<P ><FONT size=3><FONT face="Times New Roman">2 </FONT>房室间隔连续性完整，<FONT face="Times New Roman">CDFI</FONT>未见过隔血流；</FONT></P> v7 `/ l$ [3 U4 a: O0 c5 n7 z& _
<P ><FONT size=3><FONT face="Times New Roman">3 </FONT>二尖瓣前叶瓣尖略厚，回声略强，<FONT face="Times New Roman">CDFI</FONT>可见二尖瓣重度返流信号，二尖瓣形态结构未见明显异常，<FONT face="Times New Roman">CDFI</FONT>可见三尖瓣轻度返流信号，<FONT face="Times New Roman">CW</FONT>：<FONT face="Times New Roman">Vmax<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="282" UnitName="cm">282cm</st1:chmetcnv>/s</FONT>，<FONT face="Times New Roman">PG31mmHg</FONT>，主动脉瓣冠瓣叶回声略强，启闭未见明显异常，左右冠状动脉起源正常，内径正常。</FONT></P>, o. p$ \- I2 _3 T. N' `$ o6 A
<P ><FONT size=3><FONT face="Times New Roman">4 </FONT>降主动脉左锁骨下动脉发出后向动脉方向走行扭曲，最窄处为<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="6" UnitName="mm"><FONT face="Times New Roman">6mm</FONT></st1:chmetcnv>，<FONT face="Times New Roman">CDFI</FONT>：前向血流加快，<FONT face="Times New Roman">CW: Vmax<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="346" UnitName="cm">346cm</st1:chmetcnv>/s</FONT>，<FONT face="Times New Roman">PG47.9mmHg</FONT>，降主动脉狭窄后扩张为<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="19" UnitName="mm"><FONT face="Times New Roman">19mm</FONT></st1:chmetcnv>。</FONT></P>3 \0 k" `( F! u4 ]
<P ><FONT size=3>诊断：</FONT></P>- L1 r6 F5 H: K' k
<P ><FONT size=3>先天性心脏病</FONT></P>
# E3 F, q( @4 P& t8 x<P ><FONT size=3>主动脉缩窄</FONT></P>
+ ]! R Y# M/ f0 [' X& w l& q<P ><FONT size=3>二尖瓣返流（重度）</FONT></P>( Q/ H# `( c# T/ X
<P ><FONT size=3>三尖瓣返流（轻度）</FONT></P>0 j% Y# x, H @% w" V$ F. T
<P ><FONT size=3>左室大</FONT></P>
! V( [2 s; l0 M/ k4 K, o<P ><FONT size=3>左室收缩功能减低</FONT></P>/ z2 S( H' r c# _( v6 n9 `! J# B
<P align=center><B ><FONT size=3>北京市心肺血管医疗研究中心<p></p></FONT></B></P>
, z+ g. T( l9 A1 B4 C* W<P align=center><B ><FONT size=3>超声心动图示波报告<p></p></FONT></B></P>
' v+ Y+ q$ \( r/ H! u2 N+ A4 P<P ><FONT size=3>检查日期：<st1:chsdate w:st="on" IsROCDate="False" IsLunarDate="False" Day="30" Month="5" Year="2004"><FONT face="Times New Roman">2004</FONT>年<FONT face="Times New Roman">5</FONT>月<FONT face="Times New Roman">30</FONT>日</st1:chsdate></FONT></P>& O: _) H3 j9 g% s$ e; z4 J# ^
<P ><FONT size=3>阳性所见：</FONT></P>$ ?) P* n3 l! y2 \! @
<P ><FONT size=3><FONT face="Times New Roman">1 </FONT>左室呈球形扩张</FONT></P>5 h; w3 \6 V( R
<P ><FONT size=3><FONT face="Times New Roman">2 </FONT>左室壁增厚，室壁厚度及运动幅度正常，左室心内膜增厚，回声增强</FONT></P>0 u8 V+ x" K/ P9 L
<P ><FONT size=3><FONT face="Times New Roman">3 </FONT>房室间隔连续完整<FONT face="Times New Roman">CDFI</FONT>：阴性</FONT></P>8 v+ f2 b- C+ w% e2 d# N/ [( h
<P ><FONT size=3><FONT face="Times New Roman">4 </FONT>各瓣膜形态回声及启闭运动正常。<FONT face="Times New Roman">CDFI</FONT>：收缩期二尖瓣少量返流舒张期主动脉瓣微量返流。</FONT></P>: ~# |3 o$ b1 n# R7 ]) a( Q5 P
<P ><FONT size=3><st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="True" SourceValue="5" UnitName="升"><FONT face="Times New Roman">5 </FONT>升</st1:chmetcnv>主动脉内径正常，主动脉横内径<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="8" UnitName="mm"><FONT face="Times New Roman">8mm</FONT></st1:chmetcnv>，左锁骨下动脉以远<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="4.4" UnitName="mm"><FONT face="Times New Roman">4.4mm</FONT></st1:chmetcnv>处可见膜性或薄嵴性狭窄，最窄处内径<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="5" UnitName="mm"><FONT face="Times New Roman">5mm</FONT></st1:chmetcnv>，远端狭窄后扩张内径<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="12" UnitName="mm"><FONT face="Times New Roman">12mm</FONT></st1:chmetcnv>，<FONT face="Times New Roman">CDFI</FONT>见狭窄处花样血流，<FONT face="Times New Roman">CW</FONT>测得血流速度<FONT face="Times New Roman"><st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="395" UnitName="cm">395cm</st1:chmetcnv>/s</FONT>，<FONT face="Times New Roman"> PG62mmHg.</FONT></FONT></P>
9 b1 C0 g2 w9 m0 s- n/ e- s<P ><FONT size=3><FONT face="Times New Roman">6 </FONT>大动脉水平未见异常通道</FONT></P>/ a# c `% y7 t) P6 X: @
<P ><FONT size=3><FONT face="Times New Roman">7 </FONT>室间隔高位及中位至左室侧壁可见两条腱索样回声</FONT></P>
$ r! M7 Y5 m: f1 M) s<P ><FONT size=3>诊断：</FONT></P>
4 |5 U( W; E( |0 f" G3 z9 S<P ><FONT size=3>先天性心脏病</FONT></P>/ {- S" U, X$ K' Y4 s @
<P ><FONT size=3>主动脉缩窄</FONT></P>8 R2 {7 x( s0 E# S) q* w2 H
<P ><FONT size=3>左室增大，左室壁肥厚</FONT></P>
# q: o! o& E+ u4 Z<P ><FONT size=3>左室假腱索</FONT></P>8 n. z( g7 K7 M6 `: z+ l) @$ N. {
<P align=center><B ><FONT size=3>北京市心肺血管医疗研究中心<p></p></FONT></B></P> }/ D- I$ ], E/ X; T- d
<P align=center><B ><FONT size=3>超声心动图示波报告<p></p></FONT></B></P>
0 C/ W' N$ h* ]! H6 t) {, S<P ><FONT size=3>检查日期：<st1:chsdate w:st="on" IsROCDate="False" IsLunarDate="False" Day="18" Month="10" Year="2004"><FONT face="Times New Roman">2004</FONT>年<FONT face="Times New Roman">10</FONT>月<FONT face="Times New Roman">18</FONT>日</st1:chsdate></FONT></P>
4 a% P. [, N; L3 y% V$ {' m9 {8 \$ B5 C<P ><FONT size=3>阳性所见：</FONT></P># r! i, B9 y9 N+ \3 {! b/ B9 Z( ~
<P ><FONT size=3><FONT face="Times New Roman">1 </FONT>左心扩大，左室壁稍厚</FONT></P>6 O3 ?2 ^9 ] m: E: y$ g, s
<P ><FONT size=3><FONT face="Times New Roman">2 </FONT>室壁运动幅度未见异常</FONT></P>$ |) p5 b- a& p( n, {
<P ><FONT size=3><FONT face="Times New Roman">3 </FONT>房室间隔连续完整<FONT face="Times New Roman"> CDFI</FONT>：阴性</FONT></P>" A8 e2 I6 }5 p7 ]" `
<P ><FONT size=3><FONT face="Times New Roman">4 </FONT>各瓣膜形态结构正常<FONT face="Times New Roman"> CDFI</FONT>：二尖瓣少量返流</FONT></P>9 F+ w1 [4 S' E; M' V
<P ><FONT size=3><FONT face="Times New Roman">5 </FONT>降主动脉起始部内径<st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="7" UnitName="mm"><FONT face="Times New Roman">7mm</FONT></st1:chmetcnv>，远端扩张，<FONT face="Times New Roman">CDFI</FONT>：起始部血流速度增快，<FONT face="Times New Roman">CW</FONT>：<FONT face="Times New Roman">Vmax <st1:chmetcnv w:st="on" TCSC="0" NumberType="1" Negative="False" HasSpace="False" SourceValue="335" UnitName="cm">335cm</st1:chmetcnv>/s</FONT>，<FONT face="Times New Roman"> PG 45mmHg</FONT></FONT></P>, U* |* D' R/ {9 I$ R
<P ><FONT size=3>诊断：</FONT></P>
: r5 t% y v, t! n6 A# J<P ><FONT size=3>先天性心脏病</FONT></P>
+ [6 Q k" u- o5 L; x5 G* H- W<P ><FONT size=3>主动脉缩窄</FONT></P>
0 a- I7 d! Q8 G# q& u" h7 V; J<P ><FONT size=3>从目前的情况来看，病情的会不会继续发展？</FONT></P>
- }% Y4 B0 l B6 X<P ><FONT size=3>是否必须手术？</FONT></P>
2 p9 B/ `. e9 H$ i0 Y<P ><FONT size=3>不做手术对以后生长发育有什么影响？手术是否复杂？手术费用以多少？</FONT></P>) z/ N3 d6 D/ K* |0 `
<P ><FONT size=3>现在仍服用地高辛和利尿剂，一般状况还好，可以象其他小孩一样活动，请问还要服用多久？</FONT></P>
* U3 ]- N& B B+ Y: L7 r<P ><p><FONT face="Times New Roman" size=3> </FONT></p></P> |
|
IP卡
发表于 2005-1-4 03:32:30
提升卡
置顶卡
锁帖卡
变色卡
千斤顶
发表于 2005-1-5 20:38:02
