动脉导管未闭，室缺，卵圆孔未闭能否介入治疗

真爱无言

<p>陆医生，您好。</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 我在甘肃，基于当地的医疗条件，有些问题在咨询了当地的一些权威医院后，给予的结果都一大一样，故再次向你请教。期盼您能在百忙之中给予回复。谢谢。</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 我女儿现在3岁，12公斤，在她2个月大时查出患有先天性心脏病，2006年12月份复查结果如下：</p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">1.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">位置正常，各房室与大血管相对位置与连续关系正常，左房，左室内径增大，肺动脉主干内径增宽，心脏多切面观：降动脉与左肺动脉之间可见异常通道，肺动脉端宽</span><span lang="EN-US"><font face="Times New Roman">0.4CM</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">，降主动脉端宽</span><span lang="EN-US"><font face="Times New Roman">0.42CM</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">，导管长</span><span lang="EN-US"><font face="Times New Roman">0.42CM</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">，左向右分流流速为</span><span lang="EN-US"><font face="Times New Roman">4.1M/S,</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">房间隔可见过隔血流束，未见明显断端回声，彩色束宽</span><span lang="EN-US"><font face="Times New Roman">0.12CM,</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">左向右分流流速为</span><span lang="EN-US"><font face="Times New Roman">0.57M/S</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">，室间隔回声中断，左室面缺口大小为</span><span lang="EN-US"><font face="Times New Roman">0.58CM</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">，右室面缺口大小为</span><span lang="EN-US"><font face="Times New Roman">0.56CM</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">，左向右分流流速为</span><span lang="EN-US"><font face="Times New Roman">4.3M/S</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">。</span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">2.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">左室各壁运动幅度及厚度正常。</span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">3.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">各瓣膜弹性，厚度及活动正常。</span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">4.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">彩色血流观察：房水平，室水平及大血管水平左向右分流，二，三尖瓣口可见偏心型返流信号，脉冲多普勒于二尖瓣口录得</span><span lang="EN-US"><font face="Times New Roman">E/A&gt;1,</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">于三尖瓣口录得</span><span lang="EN-US"><font face="Times New Roman">E/A&gt;1.</font></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">检查结论：</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt;"><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';"></span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">1.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">先天性心脏病：</span><span lang="EN-US"><font face="Times New Roman">1</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">）室间隔缺损（膜周流入道型）</span><span lang="EN-US"><font face="Times New Roman">2</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">）动脉导管未闭（管型）</span><span lang="EN-US"><font face="Times New Roman">3</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">）卵圆孔未闭</span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">2.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">左室收缩及舒张功能正常</span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">3.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">彩色血流：房水平，室水平及大血管水平左向右分流，二，三尖瓣返流（中度）</span><span lang="EN-US" style="FONT-FAMILY: 宋体;"><p></p></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><font face="Times New Roman"><span lang="EN-US">4.</span><span lang="EN-US" style="mso-bidi-font-size: 7.0pt;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></font><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">肺动脉收缩压轻度增高（</span><span lang="EN-US"><font face="Times New Roman">34MMHG</font></span><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">）</span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';"></span></p><p class="MsoNormal" style="MARGIN: 0cm 0cm 0pt 18pt; TEXT-INDENT: -18pt; tab-stops: list 18.0pt;"><span style="FONT-FAMILY: 宋体; mso-hansi-font-family: 'Times New Roman'; mso-ascii-font-family: 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 我想咨询以下几个问题：</span></p><p><span lang="EN-US" style="FONT-SIZE: 10.5pt; FONT-FAMILY: Verdana; mso-bidi-font-size: 10.0pt;">1</span><span style="FONT-SIZE: 10.5pt; mso-hansi-font-family: Verdana; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: Verdana;"><font face="宋体">）孩子现在状况是否适合介入治疗，如果不适合，是否能做则开胸治疗</font></span><span style="FONT-SIZE: 10.5pt; FONT-FAMILY: Verdana; mso-bidi-font-size: 10.0pt;">
                </span><font face="宋体"><span style="FONT-SIZE: 10.5pt; mso-hansi-font-family: Verdana; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: Verdana;">。</span><span lang="EN-US" style="FONT-SIZE: 10.5pt; FONT-FAMILY: Verdana; mso-bidi-font-size: 10.0pt;"><p></p></span></font></p><p><span lang="EN-US" style="FONT-SIZE: 10.5pt; FONT-FAMILY: Verdana; mso-bidi-font-size: 10.0pt;">2</span><font face="宋体"><span style="FONT-SIZE: 10.5pt; mso-hansi-font-family: Verdana; mso-bidi-font-size: 10.0pt; mso-ascii-font-family: Verdana;">）孩子的肺动脉压是否较高，（当地有的大夫说肺动脉压增高已经不能再等了，必需近快做手术，有的大夫说，还可以再等孩子大一些再做。）</span><span lang="EN-US" style="FONT-SIZE: 10.5pt; FONT-FAMILY: Verdana; mso-bidi-font-size: 10.0pt;"><p></p></span></font></p><p><span lang="EN-US" style="FONT-SIZE: 10.5pt; mso-bidi-font-size: 12.0pt;"><font face="宋体">3)介入和开胸的费用大概各需要多少。<p></p></font></span></p><p></p>

陆医生

<p>因为存在三处缺损，不推荐介入治疗；</p><p>肺动脉高压并不严重，但小孩已经3岁，已经是最佳手术时机，费用3万元左右。</p>