帮帮我

2007

<p>我的宝宝现一个半月，在４２天体检时查出室间隔缺损４.５mm，嵴下型，左向右分流，左室增大．目前无明显症状，其余状况良好．想请问医生这种情况有无自愈的可能．如果手术的话有无创的吗？最佳的手术时间是什么时候？手术费用大概需要多少？还有想问问平时是否需要特殊的护理．焦急万分的父母先谢谢你们！</p><p>也希望各位好心人士提供相关信息，谢谢！</p><p>彩色超声诊断报告单如下:</p><p><font size="3"><font face="宋体">性别 男<span lang="EN-US">&nbsp; </span>年龄<span lang="EN-US">&nbsp;49</span>天<span lang="EN-US">&nbsp;&nbsp; </span>体重<span lang="EN-US">
                                        <chmetcnv wst="on" unitname="kg" sourcevalue="5.9" hasspace="False" negative="False" numbertype="1" tcsc="0">5.9KG</chmetcnv> (</span>出生时<span lang="EN-US">
                                        <chmetcnv wst="on" unitname="kg" sourcevalue="4.2" hasspace="False" negative="False" numbertype="1" tcsc="0">4.2KG</chmetcnv>)&nbsp; </span></font></font></p><p><font size="3"><font face="宋体">右室流出道内径<span lang="EN-US">:<chmetcnv wst="on" unitname="mm" sourcevalue="14.1" hasspace="False" negative="False" numbertype="1" tcsc="0">14.1MM</chmetcnv>&nbsp;&nbsp; </span>主动脉内径<span lang="EN-US">:<chmetcnv wst="on" unitname="mm" sourcevalue="14.9" hasspace="False" negative="False" numbertype="1" tcsc="0">14.9MM</chmetcnv>&nbsp; </span>主动脉瓣开放度<span lang="EN-US">: <chmetcnv wst="on" unitname="mm" sourcevalue="9.3" hasspace="False" negative="False" numbertype="1" tcsc="0">9.3MM</chmetcnv>&nbsp; </span>左室内径<span lang="EN-US">:<chmetcnv wst="on" unitname="mm" sourcevalue="16.5" hasspace="False" negative="False" numbertype="1" tcsc="0">16.5MM</chmetcnv>&nbsp; </span></font></font></p><p><font size="3"><font face="宋体">右室内径<span lang="EN-US">: <chmetcnv wst="on" unitname="mm" sourcevalue="9.7" hasspace="False" negative="False" numbertype="1" tcsc="0">9.7MM</chmetcnv>&nbsp; </span>室间隔厚<span lang="EN-US">:<chmetcnv wst="on" unitname="mm" sourcevalue="5.2" hasspace="False" negative="False" numbertype="1" tcsc="0">5.2MM</chmetcnv>&nbsp;&nbsp; </span>左室舒张末内径<span lang="EN-US">: <chmetcnv wst="on" unitname="mm" sourcevalue="25.8" hasspace="False" negative="False" numbertype="1" tcsc="0">25.8MM</chmetcnv>&nbsp; </span>左室收缩末径<span lang="EN-US">:<chmetcnv wst="on" unitname="mm" sourcevalue="15.7" hasspace="False" negative="False" numbertype="1" tcsc="0">15.7MM</chmetcnv>&nbsp;&nbsp; </span></font></font></p><p><font size="3"><font face="宋体">左室后壁厚<span lang="EN-US">:<chmetcnv wst="on" unitname="mm" sourcevalue="4" hasspace="False" negative="False" numbertype="1" tcsc="0">4.0MM</chmetcnv>&nbsp;&nbsp; </span>肺动脉内径<span lang="EN-US">: <chmetcnv wst="on" unitname="mm" sourcevalue="11" hasspace="False" negative="False" numbertype="1" tcsc="0">11.0MM</chmetcnv>&nbsp;&nbsp; </span>肺动脉流速<span lang="EN-US">: <chmetcnv wst="on" unitname="cm" sourcevalue="141" hasspace="True" negative="False" numbertype="1" tcsc="0">141 CM</chmetcnv>/S&nbsp;&nbsp; </span>二尖瓣<span lang="EN-US">E</span>峰流速<span lang="EN-US">: <chmetcnv wst="on" unitname="cm" sourcevalue="94" hasspace="True" negative="False" numbertype="1" tcsc="0">94 CM</chmetcnv>/S&nbsp;&nbsp;</span></font></font></p><p><font size="3"><font face="宋体"><span lang="EN-US">&nbsp;</span>二尖瓣<span lang="EN-US">A</span>峰流速<span lang="EN-US">:<chmetcnv wst="on" unitname="cm" sourcevalue="124" hasspace="True" negative="False" numbertype="1" tcsc="0">124 CM</chmetcnv>/S</span></font></font></p><p><font size="3"><font face="宋体">二维及<span lang="EN-US">M</span>型超声心动图扫查<span lang="EN-US">:</span></font></font></p><p><font size="3"><font face="宋体">心脏左室内径增大<span lang="EN-US">(<chmetcnv wst="on" unitname="mm" sourcevalue="16.5" hasspace="False" negative="False" numbertype="1" tcsc="0">16.5MM</chmetcnv>),</span>其余各房室内径正常<span lang="EN-US">,</span>主肺动脉内径正常<span lang="EN-US">.</span>各室壁不厚<span lang="EN-US">,</span>回声正常<span lang="EN-US">,</span>各壁运动幅度尚正常<span lang="EN-US">,</span>未见明显异常节段性运动<span lang="EN-US">,</span>左室射血分数及短轴率正常<span lang="EN-US">.</span>室间隔与左室后壁呈反向运动<span lang="EN-US">,</span>乳头肌运动未见异常<span lang="EN-US">.</span>房间隔连续性好<span lang="EN-US">,</span>未见回声中断<span lang="EN-US">.</span>室间隔膜部周部见回声中断<span lang="EN-US">,</span>断端宽约<chmetcnv wst="on" unitname="mm" sourcevalue="4.5" hasspace="False" negative="False" numbertype="1" tcsc="0"><span lang="EN-US">4.5MM</span></chmetcnv><span lang="EN-US">.</span>心包腔及心腔内未见异常回声<span lang="EN-US">.</span></font></font></p><p><font size="3"><font face="宋体">彩色及频谱和组织多普勒扫查<span lang="EN-US">:</span></font></font></p><p><font size="3"><font face="宋体">房间隔水平未见异常血流信号<span lang="EN-US">,</span>室间隔膜部周部见左向右分流的穿隔血流信号自左室经断端入右室<span lang="EN-US">,PW</span>于右室侧探及收缩期湍流频谱<span lang="EN-US">.</span>二尖瓣<span lang="EN-US">E</span>峰大于<span lang="EN-US">A</span>峰<span lang="EN-US">,</span>血流速正常<span lang="EN-US">.</span>各瓣膜区未见明显异常血流信号<span lang="EN-US">.</span>组织多普勒探查各室壁运动协调<span lang="EN-US">,</span>未见明显异常节段性运动<span lang="EN-US">.</span></font></font></p><p><font size="3"><font face="宋体">超声提示<span lang="EN-US">:</span>先天性心脏病<span lang="EN-US">:</span>室间隔缺损<span lang="EN-US"> (</span>嵴下型，左向右分流<span lang="EN-US">)</span></font></font></p><p><font size="3"><font face="宋体">我家宝宝睡觉时常常烦躁的扭动全身<span lang="EN-US">,</span>睡不久<span lang="EN-US">,</span>一小时左右就醒<span lang="EN-US">,</span>呼吸声较粗<span lang="EN-US">,</span>偶尔打喷嚏<span lang="EN-US">,</span>这和先心有关吗<span lang="EN-US">?</span></font></font></p><p></p>

陆医生

您好：<br/>&nbsp;&nbsp;&nbsp; 建议半岁复查一次，看有无自愈倾向。

2007

<p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><span style="COLOR: black; mso-bidi-font-family: Tahoma; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma;"><font face="宋体">医生您好，</font></span></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><span style="COLOR: black; mso-bidi-font-family: Tahoma; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma;"><font face="宋体">这是我孩子的B超复查报告，今天刚做的，麻烦医生帮我们看看情况有无变化，谢谢。</font></span></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><span style="COLOR: black; mso-bidi-font-family: Tahoma; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma;"></span></font><font size="3"><span style="COLOR: black; mso-bidi-font-family: Tahoma; mso-ascii-font-family: Tahoma; mso-hansi-font-family: Tahoma;"><font face="宋体">彩色超声诊断报告单如下</font></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;">:<p></p></span></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">性别 男<span lang="EN-US">&nbsp; </span>年龄<span lang="EN-US">&nbsp;</span>七个半月<span lang="EN-US">&nbsp;&nbsp; </span>体重 <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="5.9" unitname="kg" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="8.2" unitname="kg"><span lang="EN-US">8.2KG</span></chmetcnv><span lang="EN-US"> (</span>出生时 <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="4.2" unitname="kg" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="4.2" unitname="kg"><span lang="EN-US">4.2KG<chmetcnv></chmetcnv></span></chmetcnv><span lang="EN-US">)&nbsp; </span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">右室流出道内径<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="14.1" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="15.5" unitname="mm">15.5MM<chmetcnv></chmetcnv></chmetcnv>&nbsp;&nbsp; </span>主动脉内径<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="14.9" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="18.7" unitname="mm">18.7MM<chmetcnv></chmetcnv></chmetcnv>&nbsp; </span>主动脉瓣开放度<span lang="EN-US">: <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="9.3" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="11.3" unitname="mm">11.3MM<chmetcnv></chmetcnv></chmetcnv>&nbsp; </span>左室内径<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="16.5" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="18.7" unitname="mm">18.7MM<chmetcnv></chmetcnv></chmetcnv>&nbsp; </span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">右室内径<span lang="EN-US">: <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="9.7" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="6.01" unitname="mm">6.01MM<chmetcnv></chmetcnv></chmetcnv>&nbsp; </span>室间隔厚<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="5.2" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="4.24" unitname="mm">4.24MM<chmetcnv></chmetcnv></chmetcnv>&nbsp;&nbsp; </span>左室舒张末内径<span lang="EN-US">: <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="25.8" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="28.6" unitname="mm">28.6MM<chmetcnv></chmetcnv></chmetcnv>&nbsp; </span>左室收缩末径<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="15.7" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="17" unitname="mm">17.0MM<chmetcnv></chmetcnv></chmetcnv>&nbsp;&nbsp; </span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">左室后壁厚<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="4" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="3.89" unitname="mm">3.89MM<chmetcnv></chmetcnv></chmetcnv>&nbsp;&nbsp; </span>肺动脉内径<span lang="EN-US">: <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="11" unitname="mm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="11.7" unitname="mm">11.7MM<chmetcnv></chmetcnv></chmetcnv>&nbsp;&nbsp; </span>肺动脉流速<span lang="EN-US">: <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="141" unitname="cm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="124" unitname="cm">124 CM<chmetcnv></chmetcnv></chmetcnv>/S&nbsp;&nbsp; </span>二尖瓣<span lang="EN-US">E</span>峰流速<span lang="EN-US">: <chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="94" unitname="cm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="108" unitname="cm">108 CM<chmetcnv></chmetcnv></chmetcnv>/S&nbsp;&nbsp;</span>二尖瓣<span lang="EN-US">A</span>峰流速<span lang="EN-US">:<chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="124" unitname="cm" wst="on"></chmetcnv><chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="True" sourcevalue="90" unitname="cm">90 CM<chmetcnv></chmetcnv></chmetcnv>/S<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span></span>主动脉流速：<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="115" unitname="cm"><span lang="EN-US">115CM</span></chmetcnv><span lang="EN-US">/S</span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">二维及<span lang="EN-US">M</span>型超声心动图扫查<span lang="EN-US">:</span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">心脏左室内径增大，其余各房室内径正常<span lang="EN-US">,</span>主肺动脉内径正常<span lang="EN-US">.</span>各室壁不厚<span lang="EN-US">,</span>回声正常<span lang="EN-US">,</span>各壁运动幅度尚正常<span lang="EN-US">,</span>未见明显异常节段性运动<span lang="EN-US">,</span>左室射血分数及短轴率正常<span lang="EN-US">.</span>室间隔与左室后壁呈反向运动<span lang="EN-US">,</span>乳头肌运动未见异常<span lang="EN-US">.</span>房间隔连续性好<span lang="EN-US">,</span>未见回声中断<span lang="EN-US">.</span>室间隔膜部周部见回声中断<span lang="EN-US">,</span>断端宽约<chmetcnv wst="on" tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="4.63" unitname="mm"><span lang="EN-US"><chmetcnv tcsc="0" numbertype="1" negative="False" hasspace="False" sourcevalue="4.5" unitname="mm" wst="on"></chmetcnv>4.63MM</span></chmetcnv><span lang="EN-US"><chmetcnv></chmetcnv>.</span>心包腔及心腔内未见异常回声<span lang="EN-US">.</span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">彩色及频谱和组织多普勒扫查<span lang="EN-US">:</span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><font size="3"><font face="宋体"><span style="COLOR: black; mso-bidi-font-family: Tahoma;">房间隔水平未见异常血流信号<span lang="EN-US">,</span>室间隔膜部周部见左向右分流的穿隔血流信号自左室经断端入右室<span lang="EN-US">,PW</span>于右室侧探及收缩期湍流频谱<span lang="EN-US">.</span>二尖瓣<span lang="EN-US">E</span>峰大于<span lang="EN-US">A</span>峰<span lang="EN-US">,</span>血流速正常<span lang="EN-US">.</span>各瓣膜区未见明显异常血流信号<span lang="EN-US">.</span>组织多普勒探查各室壁运动协调<span lang="EN-US">,</span>未见明显异常节段性运动<span lang="EN-US">.</span></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></font></font></p><p style="BACKGROUND: white; WORD-BREAK: break-all;"><span style="COLOR: black; mso-bidi-font-family: Tahoma;"><font size="3"><font face="宋体">超声提示<span lang="EN-US">:</span>先天性心脏病<span lang="EN-US">:</span>室间隔缺损<span lang="EN-US"> (</span>嵴下型，左向右分流<span lang="EN-US">)</span></font></font></span><span lang="EN-US" style="COLOR: black; FONT-FAMILY: Tahoma;"><p></p></span></p>

wincatcher

<p>两次检查没什么区别。仍然按照以前的处理意见。</p>

2007

我也知道各位医生都很忙，但还是想请你们给我们一个建议，如果治疗的话要手术还是可以用介入？

陆医生

建议再观察半年吧，如果没有自愈可能，应考虑手术治疗；介入的话要等到3岁之后了。

2007

<p>谢谢您百忙中给我回复，现在我们家人想早点把孩子的病治好，不知是手术还是可以用介入？孩子近两个月体重没怎么增长，担心心脏会影响他的发育，孩子其它方面还不错。可我个人的意见是想再等等看，或许还有可能好转。恳请医生能再给我们一点建议，代全家人谢谢您了。</p>

2007

非常感谢陆医生，祝您及中心所有的医生天天快乐！

陆医生

不必客气。

2007

陆医生,再次麻烦您帮我看看我儿子的彩超报告,现在年龄两周九,体重约13公斤,我还想请教陆医生,我准备下个月中旬前带孩子去儿中心了,不知道如果手术的话大概要等多长时间,因为要考虑请假时间的问题.谢谢陆医生了,34
彩色超声诊断报告单如下:
* s; Q, ?2 o& Z* D
$ w' Q  w0 z: P5 ^右室流出道内径:11主动脉内径:19MM  主动脉瓣开放度: 14MM  左室内径:18MM  

; w  t& s9 ?" O) l, s$ Q9 w) H0 |. ^右室内径: 9MM  室间隔厚:5.4MM   左室舒张末内径: 33MM  左室收缩末径:21MM   


$ S& F5 @0 Z( i' V) y+ \
3 |: P5 P( D4 f( C  o左室后壁厚:5.8MM   肺动脉内径: 15MM   肺动脉流速: 94 CM/S   二尖瓣E峰流速: 113 CM/S  二尖瓣A峰流速:59 CM/S   主动脉流速：83CM/S
9 O. s. F3 N" R; O4 M! M


1 u) p1 T7 K) |二维及M型超声心动图扫查:

5 y5 G4 W" z/ o( P

' B! _6 {; t- b5 `+ a心脏左室内径增大，其余各房室内径正常,主肺动脉内径正常.各室壁不厚,回声正常,各壁运动幅度尚正常,未见明显异常节段性运动,左室射血分数及短轴率正常.室间隔与左室后壁呈反向运动,乳头肌运动未见异常.房间隔连续性好,未见回声中断.室间隔膜部周部见回声中断,断端宽约5.0MM.心包腔及心腔内未见异常回声.



彩色及频谱和组织多普勒扫查:
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房间隔水平未见异常血流信号,室间隔膜部周部见左向右分流的穿隔血流信号自左室经断端入右室,血流束宽约5.3mm,PW于右室侧探及收缩期湍流频谱.二尖瓣E峰大于A峰,血流速正常.各瓣膜区未见明显异常血流信号.组织多普勒探查各室壁运动协调,未见明显异常节段性运动.


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( H: G# A1 `/ Q8 _& l超声提示:先天性心脏病:室间隔缺损 (嵴下型，左向右分流)

wincatcher

现在手术很快就能排上了。关键是术前检查比较花时间，建议挂特需门诊。可以当天进行超声、心电图和胸片检查。这样能节省一些时间。

2007

非常感谢,我们准备挂徐教授的特需门诊

陆医生

何谓风险评估？ =