先心病室间隔缺损
我女儿2005年5月28日出生后心脏杂音特重，后查出是先天性心脏病。第一个月查时，是房间隔缺损3.3MM，室间隔缺损6MM，卵圆孔未必，肺动脉高压中度。孩子6个月时又检查只剩下室间隔缺损，肺动脉高压轻度。孩子现在19个月了，现在做了检查：CT平扫，彩超，X光，心电图。结果如下：<br/>CT检查结果<br/>影像表现：两肺纹理增多，肺内未见异常高、低密度病灶，肺门区未见病灶。器官居中，隆突形态正常，大血管形态位置正常，上纵隔宽，向左侧突出—考虑胸腺。纵隔内未见明显肿大淋巴结影，心影大。<br/>印象：两肺纹理增多，，肺内未见间实质，浸润。心影大。<br/>上纵隔宽，向左侧突出，密度均匀一考虑小儿胸腺，必要时CT增强<br/><br/>彩超所见： 左心室内径增大，右心室内径正常，室间隔与左室壁厚度正常，运动幅度偏强。室间隔膜部呈瘤样向右室侧膨凸，基地宽5MM。顶部破口约3MM；房间隔连续完整。各瓣膜形态、结构及启闭运动正常。大动脉关系及发育正常，主动脉弓降部未见异常。<br/>多普勒检查：收缩期室水平左向右高速分流信号。<br/>诊断：先天性心脏病，膜部室间隔缺损，室水平左向右分流。<br/><br/>X光片检查（不是太准，以CT为准）： 远达+左侧<br/>两肺血多，双肺透过度普遍减低；左上纵隔增宽，气管受压明显右移。肺动脉段观察不清；心脏明显增大；心胸比：0.65<br/><br/>心电图：窦性心率。<br/>现在想问问这种情况有自愈的可能吗？自愈的可能性多大？如果不能自愈，这种情况能不能做介入？我想年前去贵院约手术。盼回信！好早决定。谢谢专家在百忙之中给看看 您好：<br/> 建议继续定期复查到3岁左右。如仍未自愈，可考虑介入治疗。 <p>谢谢您在百忙之中对我问题的回答。您的回答对我的决定很重要。</p><p>我还有个问题：我女儿彩超上显示的（室间隔膜部呈瘤样向右室侧膨凸），基地宽5MM。顶部破口约3MM；这句话是不是说明有自愈的趋势。半年前做的彩超没这么说而且还大，是6MM。彩超说左心室内径增大，要不要紧？盼您的回答.谢谢！</p> 室隔瘤可以认为是自愈的表现，左室大小还可以，这不是主要矛盾所在。室间隔缺损
谢谢您的回复，非常感激！给我吃了一个定心丸。我可以放心的等等了。终于看见希望了，有咱这个论坛真是好！我还有个问题就是在群里有的患者的家长说可以食疗，给先心宝宝多吃高蛋白的东西有助于自愈，是有这方面的依据吗？主要以什么样的高蛋白的东西为主哪？ 建议父母园地进行交流。室间隔缺损和纵隔胸腺
<p class="MsoNormal" align="left" style="BACKGROUND: white; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; TEXT-ALIGN: left; mso-pagination: widow-orphan;"><span style="FONT-SIZE: 9pt; FONT-FAMILY: 宋体; mso-bidi-font-family: 宋体; mso-font-kerning: 0pt;">医生您好：我曾经问过您室缺的问题。检查结果都在上面。现在因为孩子纵隔胸腺的事还想问问您。我是在做室缺检查查出胸腺在纵隔内挤歪气管。到时这个胸腺会不会碍事？孩子做的检查您再看看，主要是在做<span lang="EN-US">X</span>光的时候孩子闹了当时，还哭着爬起来。所以不是太清楚。后来又做了个<span lang="EN-US">CT</span>平扫，这个胸腺要不要紧？会不会岁年龄增长自动消失？要不要切掉？如果必须切掉可不可以和心脏一起做？如果孩子不能自愈的话。盼回信！谢谢您在百忙之中给看看。<span lang="EN-US"><p></p></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 10pt; FONT-FAMILY: 新宋体;"><p> </p></span></p> 你从哪里看出来胸腺压迫气管？ <p>您好：我是在孩子的检查结果中看的：</p><p>X光片检查（不是太准，以CT为准）： 远达+左侧<br/>两肺血多，双肺透过度普遍减低；左上纵隔增宽，气管受压明显右移。肺动脉段观察不清；心脏明显增大；心胸比：0.65<br/>CT检查结果<br/>影像表现：两肺纹理增多，肺内未见异常高、低密度病灶，肺门区未见病灶。器官居中，隆突形态正常，大血管形态位置正常，上纵隔宽，向左侧突出—考虑胸腺。纵隔内未见明显肿大淋巴结影，心影大。<br/>印象：两肺纹理增多，，肺内未见间实质，浸润。心影大。<br/>上纵隔宽，向左侧突出，密度均匀一考虑小儿胸腺，必要时CT增强<br/></p> 你的推测毫无依据，胸腺距气管还有一段距离，且不是你的小孩的主要问题所在，我们在手术过程中常规会切除部分胸腺 <p>谢谢您的回复，这我就放心了，这一直是我的一个心病。怕这个胸腺长得碍事。这个胸腺是不是和孩子的的先心有关。这个必须切除吗？如果我家孩子自愈了不用手术的话（我只是希望），这个胸腺还要不要切除？切除对他有没有影响？瞧，我是不是问题太多了。希望您别烦我，谢谢您了。</p> 胸腺在幼儿期是一个免疫器官，随着年龄增长会逐渐萎缩。跟心脏无关。 <font size="5">谢谢您！衷心的谢谢您在百忙之中给我每次耐心及时的答复！谢谢管理员<strong><font color="#000000">admin，祝您在新的一年里身体健康！生活愉快！工作顺利！</font></strong></font> <p><font size="4">admin不好意思我还得打扰您，我今天看见我家孩子的肋骨稍有点突出，而且左侧比右侧要高，是左心室增大的原因所至吗？我家孩子最近睡觉时嗓子老是呼噜呼噜的跟有痰似的，以前也有不过比现在轻。是和那个胸腺有关吗？把部分检查结果附上。麻烦您给看一下,谢谢您了。附一点上次没写的具体数据：</font></p><p><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">左房</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">前后径</span><span lang="EN-US"><font face="Times New Roman"> 24MM<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">左房</span><span lang="EN-US"><font face="Times New Roman">/</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">主动脉</span><span lang="EN-US"><font face="Times New Roman"> 1.7MM<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">房间隔延续正常</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">左心室</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">室间隔厚度</span><span lang="EN-US"><font face="Times New Roman">6MM </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">运动与后壁</span><font face="Times New Roman"></font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">反向</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">室间隔延续</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">中断</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 52.5pt; mso-char-indent-count: 5.0;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">后壁厚度</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>6MM</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">左心房径</span><font face="Times New Roman">
</font><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">正常</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>MM<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">右心房前后径</span><span lang="EN-US"><font face="Times New Roman"> 12MM<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">肺动脉瓣结构</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">正常</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">肺动脉瓣</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">收缩期</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">流速</span><span lang="EN-US"><font face="Times New Roman">1</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">．</span><span lang="EN-US"><font face="Times New Roman">0<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">压差</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>4</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">．</span><span lang="EN-US"><font face="Times New Roman">0</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">室水平</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">左向右</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">流速</span><span lang="EN-US"><font face="Times New Roman">4</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">．</span><span lang="EN-US"><font face="Times New Roman">3<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">压差</span><span lang="EN-US"><font face="Times New Roman"> 74</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">．</span><span lang="EN-US"><font face="Times New Roman">0</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">主肺动脉径</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>17MM<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">右肺动脉径</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>9MM<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">左肺动脉径</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>8MM<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">二尖瓣</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">舒张期</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">流速</span><span lang="EN-US"><font face="Times New Roman">1.1<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">压差</span><span lang="EN-US"><font face="Times New Roman"> 4.8</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">三尖瓣</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">舒张期</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">流速</span><span lang="EN-US"><font face="Times New Roman">0.6<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">压差</span><span lang="EN-US"><font face="Times New Roman"> 1.4</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">主动脉瓣</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">收缩期</span><span lang="EN-US"><span style="mso-spacerun: yes;"><font face="Times New Roman"> </font></span></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">流速</span><span lang="EN-US"><font face="Times New Roman">1</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">．</span><span lang="EN-US"><font face="Times New Roman">0<span style="mso-spacerun: yes;"> </span></font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">压差</span><span lang="EN-US"><font face="Times New Roman"><span style="mso-spacerun: yes;"> </span>4</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'Times New Roman'; mso-hansi-font-family: 'Times New Roman';">．</span><span lang="EN-US"><font face="Times New Roman">0</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">多谱勒检查：室水平左向右高速分流</font></span></p> 胸部隆起有可能是心脏较大引起；<br/>呼吸道问题跟胸腺关系不大。
