卵圆孔未闭，三尖瓣返流，紧急求助

lauliu

<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">尊敬的专家教授：</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">我儿<chsdate year="2006" month="11" day="18" islunardate="False" isrocdate="False" wst="on"></chsdate>零六年十一月十八日晚九点<chsdate></chsdate>顺产七斤八两</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><chsdate year="2006" month="11" day="19" islunardate="False" isrocdate="False" wst="on"></chsdate>零六年十一月十九日<chsdate></chsdate>查房医生见婴儿哭泣时脸色变化较大并随唇鼻周围有偏紫色，听心音有杂音。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><chsdate year="2006" month="11" day="19" islunardate="False" isrocdate="False" wst="on"></chsdate>十一月十九日上午<chsdate></chsdate><span lang="EN-US">B</span>超检查结果附后。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">转至儿科监护室</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">当晚九点服消炎痛</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">次日九点服消炎痛</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">次日二十一点服消炎痛</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="宋体">&nbsp;</font></p></span></p><p><font face="宋体">&nbsp;</font></p><p></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">至二十二日上午<span lang="EN-US">B</span>超检查结果见后；</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">下午转至母婴房</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">次日因黄疸偏高（<span lang="EN-US">17.2</span>）再次转入儿科监护室</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">至二十七日出院，黄疸正常（<span lang="EN-US">4.7</span>）</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="宋体">&nbsp;</font><font face="宋体">附：</font></p></span></p><p><font face="宋体">&nbsp;</font><font face="宋体">附：</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">检查日期：<span lang="EN-US">19nov2006</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">设<span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp; </span></span>备：<span lang="EN-US">sono4500</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"></span></font><font face="宋体">超声所见：</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="宋体">B:A0 <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".9" unitname="cm"></chmetcnv>0.9cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>LA <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".9" unitname="cm"></chmetcnv>0.9cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span><place wst="on"></place><city wst="on"></city>LV<city></city><place></place>
5 k/ l! t8 e) ?" ~- A0 z! n                                <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.6" unitname="cm"></chmetcnv>1.6cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>IVS <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".4" unitname="cm"></chmetcnv>0.4cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>LVPW <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".3" unitname="cm"></chmetcnv>0.3cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>PA <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".8" unitname="cm"></chmetcnv>0.8cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>RA <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.1" unitname="cm"></chmetcnv>1.1cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>RV <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.4" unitname="cm"></chmetcnv>1.4cm<chmetcnv></chmetcnv></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp; </span></span>各房室腔不大，各瓣膜纤细，启闭自如，室间隔连续，主、肺动脉不宽；</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp; </span></span>室壁不厚，活动协调，心包及心包腔未见明显异常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US">M:</span>主动脉主波幅度正常，重博波可见。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US">CDFI</span>：房间隔中后段见<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".2" unitname="cm"></chmetcnv><span lang="EN-US">0.2cm</span><chmetcnv></chmetcnv>宽的红色为主的彩色血流穿隔，<span lang="EN-US">LA-&gt;RA,</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>心底短轴切面见<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".37" unitname="cm"></chmetcnv><span lang="EN-US">0.37cm</span><chmetcnv></chmetcnv>宽的红色为主的彩流束射入主肺动脉内，沿外侧壁行走，探及双期血流频谱，<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="2" unitname="m"></chmetcnv>2.0m<chmetcnv></chmetcnv>/s,Vmin<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1" unitname="m"></chmetcnv>1.0m<chmetcnv></chmetcnv>/s</span>。主、肺动脉舒张期间红色为主的彩流束进入左右室流出道，<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1" unitname="m"></chmetcnv>1.0m<chmetcnv></chmetcnv>/s Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".7" unitname="m"></chmetcnv>0.7m<chmetcnv></chmetcnv>/s.</span>二三尖瓣收缩期见蓝色为主的彩色血流束进入左右心房，<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.6" unitname="m"></chmetcnv>1.6m<chmetcnv></chmetcnv>/s Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="2" unitname="m"></chmetcnv>2.0m<chmetcnv></chmetcnv>/s</span>。余各瓣口血流速度、方向、时向正常。主、肺动脉收缩期血流呈蓝色，主动脉瓣口<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".9" unitname="m"></chmetcnv>0.9m<chmetcnv></chmetcnv>/s</span>，肺动脉瓣口<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".6" unitname="m"></chmetcnv>0.6m<chmetcnv></chmetcnv>/s</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US">TDI</span>：心壁运动正常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">心功能：<span lang="EN-US">EF80%</span>，<span lang="EN-US">FS40%</span>，<span lang="EN-US">E&gt;A</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="宋体">超声提示：动脉导管未闭</font></p></span></p><p><font face="宋体">超声提示：动脉导管未闭</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>房间隔声像改变：卵圆孔闭锁不全</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>二、三尖瓣返流</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>心功能正常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">检查日期：<span lang="EN-US">22nov2006</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">设<span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp; </span></span>备：<span lang="EN-US">sono4500</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"></span></font><font face="宋体">超声所见：</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="宋体">B:A0 <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".8" unitname="cm"></chmetcnv>0.8cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>LA <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".9" unitname="cm"></chmetcnv>0.9cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span><place wst="on"></place><city wst="on"></city>LV<city></city><place></place>
                                <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.3" unitname="cm"></chmetcnv>1.3cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>IVS <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".4" unitname="cm"></chmetcnv>0.4cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>LVPW <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".3" unitname="cm"></chmetcnv>0.3cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>PA <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".9" unitname="cm"></chmetcnv>0.9cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>RA <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.3" unitname="cm"></chmetcnv>1.3cm<chmetcnv></chmetcnv><span style="mso-spacerun: yes;">&nbsp; </span>RV <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.5" unitname="cm"></chmetcnv>1.5cm<chmetcnv></chmetcnv></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp; </span></span>右房右室稍大，左房室腔不大，三尖瓣回声稍强，开放可，关闭有错位，余瓣膜纤细，启闭自如，室间隔连续，主、肺动脉不宽，无交通；室壁不厚，活动协调，心包及心包腔未见明显异常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US">M:</span>主动脉主波幅度正常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US">CDFI</span>：房间隔中部处见<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".3" unitname="cm"></chmetcnv><span lang="EN-US">0.3cm</span><chmetcnv></chmetcnv>宽的红色为主的彩色血流穿隔，<span lang="EN-US">LA-&gt;RA,</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>二尖瓣收缩期见蓝色为主的彩色血流束进入左心房，<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="2" unitname="m"></chmetcnv>2.0m<chmetcnv></chmetcnv>/s</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>三尖瓣收缩期见蓝色为主的彩色血流进入右心房达心底部，<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="3.1" unitname="m"></chmetcnv>3.1m<chmetcnv></chmetcnv>/s</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">余各瓣口血流速度、方向、时向正常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">主、肺动脉收缩期血流呈蓝色，主动脉<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="1.1" unitname="m"></chmetcnv>1.1m<chmetcnv></chmetcnv>/s</span>，肺动脉<span lang="EN-US">Vmax<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".8" unitname="m"></chmetcnv>0.8m<chmetcnv></chmetcnv>/s</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US">TDI</span>：心壁运动正常。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">心功能：<span lang="EN-US">EF80%</span>，<span lang="EN-US">FS48%</span>，<span lang="EN-US">E&gt;A</span></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><p><font face="宋体">超声提示：房间隔声像改变：卵圆孔闭锁不全</font></p></span></p><p><font face="宋体">超声提示：房间隔声像改变：卵圆孔闭锁不全</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span>三尖瓣声像改变并重度返流</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"><span lang="EN-US"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;</span></span>二尖瓣返流</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">日前可见：</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">嘴唇稍干，脚心有蓝紫色，哭泣可见脸色变化较大、嘴唇周围颜色较深但未见发紫。</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">呼吸每分钟五十多次</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体"></font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">恳请专家教授回复：</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">我儿可否自愈？</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">如需治疗，何时较好？</font></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><font face="宋体">感谢。</font></p>

lauliu

恳请尊敬的专家教授给个指导阿，谢谢啦。

陆医生

您好：<br/>&nbsp;&nbsp;&nbsp; 动脉导管和房缺的直径都很小，不排除自愈可能，建议三个月时复查一次。

lauliu

<p>感谢专家在百忙之中的耐心答复。</p><p>还想问一下，现在的右心房增大和三尖瓣返流是不是跟过早闭合动脉导管有关呢？</p><p>消炎痛对心脏发育有副作用吗？</p><p>卵圆孔未闭我看到书上说不属于病理性的啦？</p><p>这到底是不是先天性心脏病阿？</p><p>我一直在后悔不该那么早给他服用消炎痛去闭合导管的。</p><p>再次感谢。</p>