|
|
<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>0 Y/ Q% E/ ^6 C8 B5 o2 k' J
<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>
$ B9 ?9 Y7 g! H$ y; F. A( d<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>
$ v9 m# W( e8 H6 l0 c) e<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 o3 C& l o% ~<P ><FONT size=3>扫描所见：</FONT></P>
, {7 J- r1 d) j/ u/ q2 h P<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>. u0 Z! b" A Y3 X
<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>
2 J% V3 B' j; l/ V8 a1 i<P ><FONT size=3>诊断：</FONT></P>. D. L8 M; t' \
<P ><FONT size=3>先天性心脏病：</FONT></P>; g0 O1 Q1 \+ q9 K* v
<P ><FONT face="Times New Roman"><FONT size=3>1.</FONT> </FONT><FONT size=3>主动脉缩窄；</FONT></P>/ {/ p# \( j7 E z3 f5 N5 U+ h
<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>9 J; }& [4 |$ z
<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>, f$ X9 H& G& r; K( X) r. A
<P align=center><B ><FONT size=3>超声心动图示波报告<p></p></FONT></B></P>6 Z! k. j7 F" H# N# o( j0 [
<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>
( K {4 ]9 |9 Z. r6 _6 O<P ><FONT size=3>阳性所见：</FONT></P>
: \4 B. t' s; d6 L" h<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># B, Y0 Z' K1 L& l; _6 N
<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>9 r* L) i5 q: \( s$ R5 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>
/ s) C9 ~; R3 [/ S3 Z2 u0 i<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>
, n% n0 e1 @$ t: z<P ><FONT size=3>诊断：</FONT></P>% q( |5 @: \9 y5 N, c$ _
<P ><FONT size=3>先天性心脏病</FONT></P>7 o# Z& \0 [: w9 Q
<P ><FONT size=3>主动脉缩窄</FONT></P>8 O6 ?$ @1 v- A' l
<P ><FONT size=3>二尖瓣返流（重度）</FONT></P>9 K' {: O! N% [' i. }. X
<P ><FONT size=3>三尖瓣返流（轻度）</FONT></P>0 ]+ v! S. W) f. b. {
<P ><FONT size=3>左室大</FONT></P>* K, t/ m% R1 b# u2 X
<P ><FONT size=3>左室收缩功能减低</FONT></P>
, H8 p- g" c% g" S<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>
6 Y# S! ^, N w<P align=center><B ><FONT size=3>超声心动图示波报告<p></p></FONT></B></P>
: ~: G$ m# v2 |. X( O( {. D. o; ~* N<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>& F* P! o. \& j1 J" ^
<P ><FONT size=3>阳性所见：</FONT></P>
" ?; _3 B; g5 j. c2 N5 t& j5 E<P ><FONT size=3><FONT face="Times New Roman">1 </FONT>左室呈球形扩张</FONT></P>) `- @0 q9 o* D* M8 `2 o
<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>
2 w! Q9 v* G$ \) `<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>
- i+ r# w- T6 I5 K% y ^. P<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># b8 |: v- j! x$ c0 U
<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>
. ?4 L" Q$ h% a/ F<P ><FONT size=3><FONT face="Times New Roman">6 </FONT>大动脉水平未见异常通道</FONT></P> M( G. r+ |7 N# u/ K
<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>0 f/ W0 X! }5 F# V) q
<P ><FONT size=3>诊断：</FONT></P>9 u$ o- Z" R$ t6 O1 W$ R; s0 [) R
<P ><FONT size=3>先天性心脏病</FONT></P>
; e/ G3 R* H% e, z) R<P ><FONT size=3>主动脉缩窄</FONT></P>8 z. I' o% }% W$ l
<P ><FONT size=3>左室增大，左室壁肥厚</FONT></P>$ H0 M! P$ e! }- a D
<P ><FONT size=3>左室假腱索</FONT></P>
4 G8 p# d2 C& `* \4 T<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>
; y! h2 }* W$ d# c4 r<P align=center><B ><FONT size=3>超声心动图示波报告<p></p></FONT></B></P>
r0 N- P2 d) p5 _6 J$ ?' O<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>0 ]# x. |0 ?1 ]) N, x
<P ><FONT size=3>阳性所见：</FONT></P>
# b' I5 U; @4 Q$ b) f! L O6 ]<P ><FONT size=3><FONT face="Times New Roman">1 </FONT>左心扩大，左室壁稍厚</FONT></P>' H, t6 U- Z; a2 C/ n# W2 R
<P ><FONT size=3><FONT face="Times New Roman">2 </FONT>室壁运动幅度未见异常</FONT></P>
* p8 b( U0 s8 B<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>; u1 x) D5 ~& Y) s# M5 D
<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>- s& K8 ~% v" n3 } U
<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>5 m2 G& @( m. J4 S" g6 U
<P ><FONT size=3>诊断：</FONT></P>( N* x4 O( ?; }& p0 L
<P ><FONT size=3>先天性心脏病</FONT></P>9 [7 {* d# \+ t* G
<P ><FONT size=3>主动脉缩窄</FONT></P>
' J* [) ]$ g3 o% }+ e9 H9 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>- {: u. t: n2 u/ D
<P ><FONT size=3>是否必须手术？</FONT></P>
8 n" W% _& [% d( H2 k+ M<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>
* n6 _6 p) F7 |<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>4 G, S8 ^. o9 l: l+ N
<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
