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$ y' v& Y3 z# O" d; L<P ><p><FONT face="Times New Roman" color=#000000> 小儿在出生三天时检查说心脏有轻柔的杂音，分别于出生后45天、5个月去检查，彩超报告如下：</FONT></p></P>3 | R y! [3 H+ e; d* L$ p, ~
<P ><p><FONT face="Times New Roman" color=#000000></FONT></p> </P># q. y7 @ S" j) p: W( B# X
<P ><p></p> </P>
$ x# b+ A9 h" Q- r6 f) H7 X<P ><FONT color=#000000>性别：男 年龄：<FONT face="Times New Roman">45</FONT>天</FONT></P>9 B: `- q* p3 d4 \, G) r
<P ><FONT color=#000000>仪器型号：<FONT face="Times New Roman">philips sonos 5500 </FONT> 探头频率：<FONT face="Times New Roman">2-4MHZ</FONT>，<FONT face="Times New Roman">3-8MHZ</FONT> 检查途径：经胸 检查项目：二维、<FONT face="Times New Roman">M</FONT>型、彩色、多普勒 图像质量：<FONT face="Times New Roman">B</FONT></FONT></P>) X% I4 ?7 A" o$ i0 K
<P ><FONT color=#000000><FONT face="Times New Roman">M</FONT>型超声心动图（厘米）</FONT></P>1 r6 b5 c* e) I [0 W, D1 U* w% {
<P ><FONT face="Times New Roman" color=#000000>LVDd 2.31 RVDd LVIVSd LVPWd 0.21 Ao 1.19</FONT></P>3 }2 s% X8 f4 m- b. v
<P ><FONT face="Times New Roman" color=#000000>LVDs 1.46 RVDs LVIVSs LVPWs 0.55 LA 1.31</FONT></P>
; {. O; J7 U3 E<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
, z3 [$ O% V# Z- s, e% Z$ s' p<P ><FONT color=#000000>心功能</FONT></P>
5 |& B# \9 N$ n- S" {1 f* K<P ><FONT color=#000000><FONT face="Times New Roman">LVEF</FONT> <FONT face="Times New Roman">69%</FONT> <FONT face="Times New Roman">LVFS</FONT> <FONT face="Times New Roman">37%</FONT></FONT></P>
' B/ ?: ?( y* r9 p<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>4 E( E5 r1 o' g1 B, T P1 J
<P ><FONT color=#000000>二维超声（平方厘米）</FONT></P>" o$ S: ^) y$ |8 ~' C I
<P ><FONT color=#000000><FONT face="Times New Roman">LA</FONT> <FONT face="Times New Roman">LV</FONT> <FONT face="Times New Roman">RA</FONT> <FONT face="Times New Roman">RV</FONT> <FONT face="Times New Roman">MRA</FONT> <FONT face="Times New Roman">TRA</FONT> </FONT></P>8 i0 ~- o! H2 k& ?6 ^3 J0 \
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
6 W6 b+ e3 B2 `& x; @$ }<P ><FONT color=#000000>频谱多普勒超声（米<FONT face="Times New Roman">/</FONT>秒）</FONT></P>% q4 l# _; \; k. s# H# ^& ^
<P ><FONT face="Times New Roman" color=#000000>AAo 1.0 DAo 1.6 LVOT RVOT MPA 1.2</FONT></P>
3 T; t7 e" O& d<P ><FONT color=#000000><FONT face="Times New Roman">MV 0.8 TV0.6 </FONT>跨瓣压差 <FONT face="Times New Roman">mmHg</FONT></FONT></P>
& y% V |. H- o) a; m7 S<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>4 e4 c3 ]2 f7 K, v
<P ><FONT color=#000000>彩色多普勒超声</FONT></P>
# [& Z0 X. A9 B2 v2 D<P ><FONT color=#000000><FONT face="Times New Roman">MR</FONT> 阴性 <FONT face="Times New Roman">AI</FONT> 阴性 <FONT face="Times New Roman">TR</FONT> 轻微<FONT face="Times New Roman">2.2m/s </FONT> <FONT face="Times New Roman">PI</FONT> 轻微</FONT></P>
2 h" U4 b: l* h' i- F4 F<P ><FONT color=#000000>心房水平左向右分流 心室水平无分流 大动脉水平左向右分流</FONT></P>- N C% Q0 m( O3 a) Y
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>- y8 R6 T) t6 G* Z% X, u5 q1 T% P7 u1 g
<P ><FONT color=#000000>超声所见</FONT></P>: e9 a7 l" |- _& U
<P ><FONT color=#000000>心脏位置及连接正常，房室腔无扩大，左室收缩活动可。主动脉、肺动脉无增宽。各瓣膜开放活动正常。卵圆孔未闭，细束左向右分流。室间隔完整。左位主动脉弓。动脉导管未闭，细丝左向右分流，二维显示不清。</FONT></P>
, q1 `3 l' y* t. E" n# j<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
9 d8 i h/ Z; _: X3 T& y9 p<P ><FONT color=#000000>提示</FONT></P>3 q8 k V; m+ S( X4 q5 n6 a
<P ><FONT color=#000000>卵园孔未闭</FONT></P>
& I: s& ~' a0 @) w1 k4 l<P ><FONT color=#000000>动脉导管未闭（小）</FONT></P>
. {! M/ _5 g9 x: \<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
1 J- ]: U6 K1 h( J D<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>) {+ m# K6 [1 f# R" C k1 }" _
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<P ><FONT color=#000000><FONT face="Times New Roman">5</FONT>个月后检查结果如下，检查时有轻微咳嗽</FONT></P>
: E. K2 Q m% C# g [& g4 ]4 f<P ><FONT color=#000000>性别：男 年龄：<FONT face="Times New Roman">5</FONT>个月</FONT></P>) c1 o9 `. I: U- ?. i, b2 Z
<P ><FONT color=#000000>仪器型号：<FONT face="Times New Roman">philips sonos 5500 </FONT> 探头频率：<FONT face="Times New Roman">2-4MHZ</FONT>，<FONT face="Times New Roman">3-8MHZ</FONT> 检查途径：经胸 检查项目：二维、<FONT face="Times New Roman">M</FONT>型、彩色、多普勒 图像质量：<FONT face="Times New Roman">B</FONT></FONT></P>; H; M) G4 n; t- @1 e
<P ><FONT color=#000000><FONT face="Times New Roman">M</FONT>型超声心动图（厘米）</FONT></P>6 w# C- G3 k1 H) V* D
<P ><FONT face="Times New Roman" color=#000000>LVDd 2.35 RVDd LVIVSd LVPWd 0.32 Ao 1.34</FONT></P>
* @) |6 p! b) u! R& y<P ><FONT face="Times New Roman" color=#000000>LVDs 1.41 RVDs LVIVSs LVPWs 0.57 LA 1.41</FONT></P>- ~0 N' j3 ~1 n1 V' ^; }
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P># d3 w+ K" S. b1 m
<P ><FONT color=#000000>心功能</FONT></P> Y) S) V( ~1 A3 G" `" A# ^0 B' m
<P ><FONT color=#000000><FONT face="Times New Roman">LVEF</FONT> <FONT face="Times New Roman">73%</FONT> <FONT face="Times New Roman">LVFS</FONT> <FONT face="Times New Roman">40%</FONT></FONT></P>3 }( p0 y# L5 ]% x4 u+ O
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>) ~* J% |0 X; N- s
<P ><FONT color=#000000>二维超声（平方厘米）</FONT></P>6 ^- ?) z5 R3 n" W4 i
<P ><FONT color=#000000><FONT face="Times New Roman">LA</FONT> <FONT face="Times New Roman">LV</FONT> <FONT face="Times New Roman">RA</FONT> <FONT face="Times New Roman">RV</FONT> <FONT face="Times New Roman">MRA</FONT> <FONT face="Times New Roman">TRA</FONT> </FONT></P>/ j# G4 v5 c& q0 g j/ ^8 S9 {. w
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>& Z, ^( `* A# D( G7 N) N! {
<P ><FONT color=#000000>频谱多普勒超声（米<FONT face="Times New Roman">/</FONT>秒）</FONT></P>
+ t' R3 |9 l, _$ K, N( i+ c, l<P ><FONT face="Times New Roman" color=#000000>AAo 1.1 DAo 1.2 LVOT RVOT MPA 1.6</FONT></P>
) Z. ?, h$ j3 l" Y6 ?- r8 M<P ><FONT color=#000000><FONT face="Times New Roman">MV 0.9 TV0.6 </FONT>跨瓣压差 <FONT face="Times New Roman">mmHg</FONT></FONT></P>& L0 \4 ~1 P8 W
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
3 U. l# ]6 a& y2 l6 C<P ><FONT color=#000000>彩色多普勒超声</FONT></P>' y0 H. H; l2 _! A9 N) Q1 c4 c2 C: t
<P ><FONT color=#000000><FONT face="Times New Roman">MR</FONT> 阴性 <FONT face="Times New Roman">AI</FONT> 阴性 <FONT face="Times New Roman">TR</FONT> 轻微 <FONT face="Times New Roman">PI</FONT> 轻微</FONT></P>
1 r7 i& v- `, `' p( v<P ><FONT color=#000000>心房水平无分流 心室水平无分流 大动脉水平左向右分流 分流<FONT face="Times New Roman">2.5m/s</FONT></FONT></P>7 c# P% O/ p8 ^+ {
<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
) n& D" D- d6 y. u+ H% h<P ><FONT color=#000000>超声所见</FONT></P>& Q0 C" Q7 l- S9 J$ c
<P ><FONT color=#000000>心脏位置及连接正常。各房室腔无明显增大，左室收缩活动可。主动脉无增宽。肺动脉稍增宽，肺动脉总干流速<FONT face="Times New Roman">1.6m/s</FONT>，左肺动脉流速<FONT face="Times New Roman">1.2m/s</FONT>。各瓣膜开放活动可。房间隔未见明显缺损，心房水平无明显分流。室间隔完整。动脉导管二维直接征象不明显，彩色多普勒超声显示左肺动脉起始处舒张期细束左向右分流，分流速<FONT face="Times New Roman">2.5m/s</FONT>。左位主动脉弓。</FONT></P>
) ~' T0 D( t+ z; n- P8 Z<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>+ B U! s: s1 z5 c
<P ><FONT color=#000000>提示</FONT></P>. z1 K" {( h6 C/ Y" a: O8 a
<P ><FONT color=#000000>动脉导管未闭（细束分流）</FONT></P>* K' N# g" R3 n+ N( B$ [# }
<P ><FONT color=#000000>右肺动脉流速稍增快<FONT face="Times New Roman">2.0m/s</FONT></FONT></P>
" t% l& y9 j3 B0 L# _<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>0 x' c& R0 F2 m. f
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% |" k9 O) b9 N+ e4 |2 f<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>
4 Z% a, u. V: Y6 _$ |3 P3 s<P ><FONT color=#000000>医生建议半年以后复查。我想请教专家的是：轻微的咳嗽是否会引起肺动脉的增宽？从这两份检查的报告来看，动脉导管能否自愈？自愈的时间是一周岁以前还是六个月以前？<FONT face="Times New Roman"> </FONT></FONT></P>
* V- d' R+ |% f* D2 s( u# v" M<P ><p><FONT face="Times New Roman" color=#000000> </FONT></p></P>" q f. n" W- ^2 o
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发表于 2005-9-24 20:26:40
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