湘雅儿科精品-Congenital Heart Disease课件.pptVIP

●青紫：本病最突出的症状 Cyanosis is the main symptoms ●气促和缺氧发作 Dyspnea and hypoxemic spells ●蹲踞症状 Squatting posture ●心脏体征 LSB2-4闻及 2-4/6级收缩期喷射性杂音 There is a grade Ⅱ-Ⅳ/Ⅵ, rough, ejection-type SM that is maximal at the LSB in the 2nd to 3rd intercostal space and that radiates well to the back ●杵状指趾 Clubbing of the terminal digits TOF临床表现Clinical findings of TOF 杵状指 Clubbing of fingers 杵状指趾 Clubbing of fingers and toes ●脑血栓 Cerebral embolism ●脑脓肿Cerebral abscess ●感染性心内膜炎Infective endocarditis 法洛四联症并发症Complication of TOF X Ray of TOF X线检查右室大、心尖上翘呈靴形，肺动脉段凹陷，肺野清晰 先天性心脏病的诊断Diagnosis of CHD ●病史History ●体查Physical examination ●心电图Electrocardiogram ●心脏X线检查Chest X-ray ●超声心动图Echocardiogram ●心导管检查和心血管造影Cardiac catheterization and angiocardiography 临床上有诊断意义的心脏杂音Clinical significance heart murmur ●全收缩期杂音 Pansystolic murmur ●收缩晚期杂音 Late systolic murmur ●舒张期杂音 Diastolic murmur ●连续性杂音 Continuous murmur ●强度≥3/6级的杂音Grade ≥ 3/6 murmur 先天性心脏病的治疗Treatment of CHD ●内科治疗 Medical management 治疗心衰，良好护理 Anticongestive heart failure measures, good nursing ●外科治疗 Operation treatment 开胸心脏修补手术 Repair the defect through transthoracic cardiac surgery operation ●介入治疗Interventional treatment 利用堵闭器材导管关闭继发孔ASD和PDA Catheterization closure with an interventional device is generally recommended for ostium secundum ASD and PDA ASD介入治疗 Interventional treatment of ASD ASD闭合器 * * 先天性心脏病 Congenital Heart Disease (CHD) Dept. Pediatric of 2nd Xiangya Hospital of CSU Wang Cheng 中南大学儿科学教研室 第十三章 概述 Overview CHD is defined as an abnormality in circulatory structure or function that is present at birth, even if it is discovered much later CHD is present in 0.687% in China 先天性心脏病是胎儿时期心脏血管发育异常而导致的先天性畸形 出生后1年内先天性心血管发育畸形出现率占活产婴儿的6.87‰ By the progression of all kinds of inspection techniques and interventional therapy, the prognosis of CHD has taken on a new look. 概述 Overview 由于各种心血管检查技术（特别是彩色多普勒超声心动图）的应用，深低温麻醉和体外循环下心内直视手术的发展，先心病介入性治疗进展，临床上对先心病的诊断和治疗发生了很大变化 ，预后大为改观。 目的要求 Objective and Request ●掌握室间隔缺损、房间隔缺损、动脉导