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关于主动脉瓣上狭窄的咨询

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发表于 2007-5-4 23:34:01 | 显示全部楼层 |阅读模式
<p>ADMIN:您好,我儿子现在4岁8个月,从出生至今心脏有杂音,但无其它明显症状</p><p>今天在深圳儿童医院做了超声检查(未服镇静药物),结果如下:</p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">M</font></span></b><b style="mso-bidi-font-weight: normal;"><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">型超声心动图</span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></b></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">RVD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="10" unitname="mm">10mm</chmetcnv><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span>ARD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="13" unitname="mm">13mm</chmetcnv><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">LVD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="32" unitname="mm">32mm</chmetcnv><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span>ASD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="15" unitname="mm">15mm</chmetcnv><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">LVS<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="17" unitname="mm">17mm</chmetcnv><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>PAD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="14" unitname="mm">14mm</chmetcnv><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">IVS<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="6" unitname="mm">6mm</chmetcnv><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>LPAD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="8" unitname="mm">8mm</chmetcnv><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">LVPW <chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="6" unitname="mm">6mm</chmetcnv><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span>RPAD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="8" unitname="mm">8mm</chmetcnv><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">LAD<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="17" unitname="mm">17mm</chmetcnv><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span>LVOT<span style="mso-spacerun: yes;">&nbsp; </span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="12" unitname="mm">12mm</chmetcnv><p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">EF<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp; </span>79%<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>FS<span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp; </span>48%<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><p><font face="Times New Roman">&nbsp;</font></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><b style="mso-bidi-font-weight: normal;"><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">二维超声心动图</span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></b></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">IAS<span style="mso-spacerun: yes;">&nbsp; </span></font></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">正常</span><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">IVS<span style="mso-spacerun: yes;">&nbsp; </span></font></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">正常</span><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">PE<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span></font></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">无</span><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><p><font face="Times New Roman">&nbsp;</font></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><b style="mso-bidi-font-weight: normal;"><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">多普勒超声心动图</span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></b></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">Vmax(m/sec)<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">AV<span style="mso-spacerun: yes;">&nbsp; </span>3.1<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">MV<span style="mso-spacerun: yes;">&nbsp; </span>1.2/0.7<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">PV<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>1.3<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">TV<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>0.7/0.5<p></p></font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-SIZE: 14pt;"><span style="mso-spacerun: yes;"><font face="Times New Roman">&nbsp;</font></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-SIZE: 14pt;"><span style="mso-spacerun: yes;"><font face="Times New Roman">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </font></span></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">心房正位,心室右袢。心脏各房室内径正常大小,房、室间隔回声延续正常。主动脉瓣尖回声稍增强,余各瓣膜结构未显示明显异常。主、肺动脉位置关系正常,主动脉瓣上距瓣环</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="6" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">6mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">处显示嵴样隆起,局部官腔狭窄,内径</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="8" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">8mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">,其远段官腔稍扩张,内径</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="14" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">14mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">,主动脉瓣环、升部、弓部、降部内径分别为</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="15" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">15mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">、</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="13" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">13mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">、</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="10" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">10mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">、</span><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="11" unitname="mm"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">11mm</font></span></chmetcnv><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">。冠状动脉开口位置及内径未显示异常。心包未显示积液回声。</span><span lang="EN-US" style="FONT-SIZE: 14pt;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>CDFI</font></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体; mso-ascii-font-family: &quot;Times New Roman&quot;; mso-hansi-font-family: &quot;Times New Roman&quot;;">心内未显示异常血流信号。主动脉血流速度增快,</span><span lang="EN-US" style="FONT-SIZE: 14pt;"><font face="Times New Roman">Vmax3.1/s</font></span><span lang="EN-US" style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">,</span><b style="mso-bidi-font-weight: normal;"><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">⊿<span lang="EN-US">P 38mmHg,</span></span></b><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">舒张期主动脉瓣口显示少量反流信号。其余瓣口血流未见明显异常。<span lang="EN-US"><p></p></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span lang="EN-US" style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;"><p>&nbsp;</p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><b style="mso-bidi-font-weight: normal;"><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">超声诊断:<span lang="EN-US"><p></p></span></span></b></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 42pt; mso-char-indent-count: 3.0;"><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">先天性心脏病<span lang="EN-US"><p></p></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 42pt; mso-char-indent-count: 3.0;"><span lang="EN-US" style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;"><span style="mso-spacerun: yes;">&nbsp; </span></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">主动脉瓣上狭窄<span lang="EN-US"><p></p></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 42pt; mso-char-indent-count: 3.0;"><span lang="EN-US" style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;"><span style="mso-spacerun: yes;">&nbsp; </span></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">主动脉瓣上反流(少量)<span lang="EN-US"><p></p></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 42pt; mso-char-indent-count: 3.0;"><span lang="EN-US" style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;"><span style="mso-spacerun: yes;">&nbsp; </span></span><span style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;">心脏整体功能指标正常<span lang="EN-US"><p></p></span></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt; TEXT-INDENT: 42pt; mso-char-indent-count: 3.0;"><span lang="EN-US" style="FONT-SIZE: 14pt; FONT-FAMILY: 宋体;"><p>&nbsp;</p></span></p><p>请问:1、做一次检查是否就可以最终确定结果?</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2、如果按这个检查结果是否需要做手术?如果需要做,什么时间做手术最好?</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 3、做这样的手术风险大吗?术后效果如何?</p><p>谢谢!!!</p>
     
发表于 2007-5-5 22:55:43 | 显示全部楼层
这种疾病超声基本可以明确诊断,一般瓣上压差超过50mmHg为手术指证,处理起来比较麻烦,切除瓣上纤维后,有可能在以后再次复发。
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 楼主| 发表于 2007-5-7 02:00:05 | 显示全部楼层
<p>感谢陆医生回复!</p><p>我想再问一下,您说这种疾病压差未超过50mmHg不适合做手术,而且手术后有可能复发,那么如果现在</p><p>不做手术,以后孩子的病情会如何发展?在孩子的生长发育过程中家长应该注意哪些事项?</p>
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发表于 2007-5-7 04:40:42 | 显示全部楼层
现在能做的就是定期复查。
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 楼主| 发表于 2007-5-7 17:21:04 | 显示全部楼层
<p>陆医生,你好!请问定期检查的周期一般是多长时间?如果我下次带孩子去你们那里复查,需要提前预约吗?</p>
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发表于 2007-5-8 05:02:11 | 显示全部楼层
<p>建议三个月到半年复查一次,预约可以快速得到检查结果,推荐。</p>
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