求助,导管未闭,室间膜缺损治疗.

xuyanxjj

<p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman"><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue=".9" unitname="cm">彩超结果:</chmetcnv></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">左房增大</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">余房室不大</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">主动脉</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">肺动脉内径不宽</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">各瓣膜回声纤细</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">活动度较好</span><span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">室间隔与左室后壁不厚</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">两者呈逆向运动</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">心尖四腔切面及大动脉短轴切面均可见室间隔膜周部回声失落</span><span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">间距约</span><span lang="EN-US"><font face="Times New Roman">0.8cm,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">心底短轴切面于主动脉</span><span lang="EN-US"><font face="Times New Roman">11</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">点处见回声失落</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">在心底短轴切面见肺动脉分叉处与降主动脉之间有导管沟通</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">导管宽约</span><span lang="EN-US"><font face="Times New Roman">0.2-0.3cm </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">长约</span><span lang="EN-US"><font face="Times New Roman">0.4cm</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">CDFI </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">在二维彩超图显示室间隔膜部缺口处</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">见收缩期红色为主的五彩镶嵌与缺损口大小相似宽度的血流束</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">自左室经缺损口进入右室</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">在缺损口右室面可测得收缩期充填型多普勒频谱</span><span lang="EN-US"><font face="Times New Roman">VP<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="2.57" unitname="m">2.57m</chmetcnv>/s<span style="mso-spacerun: yes;">&nbsp; </span>PG26.6mmHg</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">CDFI </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">心底短轴切面于收缩期</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">舒张期均可见红色为主五彩镶嵌血流束经动脉导管进入肺动脉分叉处</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">沿肺动脉外侧逆行至肺动脉瓣</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">测得双期连续正向湍流频谱</span><span lang="EN-US"><font face="Times New Roman">VP<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="5" unitname="m">5.0m</chmetcnv>/s PG100mmHg,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">舒张期明显</span><span lang="EN-US"><font face="Times New Roman">.</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">这是我儿子</span><span lang="EN-US"><font face="Times New Roman">41</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">天时检查出的结果</span><span lang="EN-US"><font face="Times New Roman">. </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">当时体重是</span><span lang="EN-US"><font face="Times New Roman">:9.5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">斤</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">身高</span><span lang="EN-US"><font face="Times New Roman">,<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="53" unitname="cm">53 cm</chmetcnv></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">足月顺产的</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">出生体重</span><span lang="EN-US"><font face="Times New Roman">6</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">斤</span><span lang="EN-US"><font face="Times New Roman">2</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">两</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">身高</span><span lang="EN-US"><font face="Times New Roman">:50cm</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">40</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">天</span><span lang="EN-US"><font face="Times New Roman">:</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">体重是</span><span lang="EN-US"><font face="Times New Roman">:9.5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">斤</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">身高</span><span lang="EN-US"><font face="Times New Roman">,<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="53" unitname="cm">53 cm</chmetcnv></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">60</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">天体重</span><span lang="EN-US"><font face="Times New Roman">:11.5</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">斤</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">身高</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="56" unitname="cm"><span lang="EN-US"><font face="Times New Roman">56cm</font></span></chmetcnv></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">90</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">天</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">体重</span><span lang="EN-US"><font face="Times New Roman">:13</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">斤</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">身高</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="58" unitname="cm"><span lang="EN-US"><font face="Times New Roman">58cm</font></span></chmetcnv></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">现在快</span><span lang="EN-US"><font face="Times New Roman">100</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">天了</span><span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">一直是少食多餐</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">混合喂养</span><span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">平时</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">就是喝奶粉时</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">总是容易呛着</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">接着会咳嗽一下</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">然后就会吐奶</span><span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">不知与这个先心有没有关系</span><span lang="EN-US"><font face="Times New Roman">.</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">提问</span><span lang="EN-US"><font face="Times New Roman">1: </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">什么时候再去做检查</span><span lang="EN-US"><font face="Times New Roman">?</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">2:</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">有复合的希望吗</span><span lang="EN-US"><font face="Times New Roman">?</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US"><font face="Times New Roman">3:</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">采用最好的</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">进口的</span><span lang="EN-US"><font face="Times New Roman">,</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">可以用介入治疗吗</span><span lang="EN-US"><font face="Times New Roman">?</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">费用约是多少</span><span lang="EN-US"><font face="Times New Roman">?</font></span></p>

陆医生

您好：<br/>&nbsp;&nbsp;&nbsp; 建议半岁复查一次吧，缺损看起来相对较大。

xuyanxjj

<p><strong><font color="#ff0000">admin：</font></strong></p><p>非常感谢医生的回复!终于等到第二天又来发贴提问.</p><p>我们全家人都想知道:1、我儿子的两种心脏畸型，可以到三岁之后，采用介入治疗吗？能不开胸吗？或者说目前有没有药物可以让他坚持到三岁再做治疗。三岁之前做手术怕孩子太小，伤害大。</p><p>2、手术治疗和介入治疗都采用最好的材料。分别需要多少费用？</p><p>再次感谢医生百忙中给我们答复。谢谢。</p><p></p>

陆医生

两处缺损进行介入是较贵的，可能要接近7、8万，手术治疗的话3万元左右。

xuyanxjj

<p><strong><font color="#ff0000">admin:</font></strong></p><p><strong><font color="#ff0000">&nbsp; 谢谢你的回复.今天再一次登录上来.我是江苏人,但在广州生活.因为离得比较远,今天让我爸爸拿着我儿子的B超单直接去你们医院挂徐志伟的号.因为没有提前预约,没有挂到.</font></strong></p><p><strong><font color="#ff0000">&nbsp;&nbsp; 我想问问,可以等到我儿子三岁是可以采用介入治疗的是吗?钱多钱少不在乎那么多了,只希望让他的创伤与痛苦降到最低点.让他的人生走得平坦一些.</font></strong></p><p><font color="#ff0000"><strong>&nbsp;&nbsp;&nbsp;真的可以坚持到三岁再做介入治疗吗????&nbsp;&nbsp; 备注:</strong></font><font color="#000000">室间隔膜周部回声失落<span lang="EN-US"><font face="Times New Roman">.</font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">间距约</span><span lang="EN-US"><font face="Times New Roman">0.8cm&nbsp;&nbsp;&nbsp;&nbsp; <span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">导管宽约</span><span lang="EN-US"><font face="Times New Roman">0.2-0.3cm </font></span><span style="FONT-FAMILY: 宋体; mso-ascii-font-family: 'mso-hansi-font-family:';">长约</span><span lang="EN-US"><font face="Times New Roman">0.4cm&nbsp; 未闭.</font></span></font></span></font></p><p>&nbsp;&nbsp;&nbsp; 谢谢.过几天就可以收到在徐志伟医生写的书了.</p>

陆医生

问题就在于你们能否等待这么长时间，因为缺损较大，时间长了可能会出现肺动脉高压，个人意见还很及早手术为好。

xuyanxjj

<p><strong><font color="#ff0000">admin:</font></strong></p><p><strong><font color="#ff0000">&nbsp;&nbsp; 我儿子可以游泳吗?家里有个游泳池子.只给他游过两次.</font></strong></p><p><strong><font color="#ff0000">&nbsp;&nbsp; 谢谢!</font></strong></p>

xuyanxjj

<p><strong><font color="#ff0000">admin:</font></strong></p><p><strong><font color="#ff0000">&nbsp; 没有回复我的,是忙吗,还是没有看到呢?等待中.</font></strong></p>

xuyanxjj

<p><strong><font color="#ff0000">admin:</font></strong></p><p><strong><font color="#ff0000">&nbsp;&nbsp;&nbsp; 我儿子喉咙里从出生到现在一直有痰,喝奶喉咙里也有咕喽咕喽的,如果咳一下,就很容易吐奶.不发烧.平时听他喉咙里总是呼哧呼哧的,有痰卡着一样,每次吐的奶里都有很粘的痰.连着的.他这是怎么了?是不是游泳了的?还是洗澡着凉了呢?这些都是在水温37度,室温26度的.严格控制的.还是出生时的痰没有吸出来呢?这痰影响他喝奶,会容易吐奶.</font></strong></p><p><strong><font color="#ff0000">&nbsp;&nbsp; &nbsp;&nbsp; </font></strong></p>