法洛四联症精品课件.ppt

法洛四联症;法洛四联症Tetralogy of Fallot，TOF ;发病率Incidence ;病理解剖Anatomic pathology;Normal Heart;;病理生理及血液动力学改变 主要取决于肺动脉狭窄的程度 ;右心房 ;临床表现Clinical Manifestations;;临床表现Clinical Manifestations;;;临床表现Clinical Manifestations;;临床表现Clinical Manifestations;;;听诊：胸骨左缘第2～4肋间有2～4／6级喷射性收缩期杂音 P2减弱 ; 电轴右偏 右心室肥厚，V1呈rsR等右束支传导阻滞的图型 可出现高尖P波 左心室占优势者非常少见，若TOF患者心电图显 示电轴不偏，左心室肥厚或双心室大的任何一 个证据，均应考虑合并有PDA，多属于非发绀型 四联症;心电图Electrocardiography; TOF典型的X线表现为“靴型心”，心尖圆钝上 翘，心腰凹陷或平直 心胸比例多数正常，或右心室轻至中度增大， 右心房可轻度增大 肺门影缩小，肺野血管纤细 主动脉常向右前移位，致上纵隔影增宽 若出现肺纹理增多和左心室增大时，应考虑 合并有PDA或侧支循环形成;; 二维超声对TOF的诊断有特异性价值 可显示室间隔与主动脉前壁连续中断 主动脉根部前壁前移，主动脉骑跨在室间隔上，主动脉后壁与二尖瓣前叶有纤维连续 右心室内径增大，右心室流出道狭窄，右室前壁及室间隔增厚;;;;心导管及造影Cardiac Catheterization;;;;并发症Complications;治疗Treatment;治疗Treatment;治疗Treatment;;TOF-1;TOF- 2;Dn7$Mwg0VFp9Oyi2XHrb*QAk4YJtd)RCm6#Lvf+TEo8$Mxh1VFqaOyj3XHrc(QAl5ZJte-SCm7!Lvf0UEo8%Nxh2WGqa*Pzj3YIsc(RBl5ZKue-SDn7!Mwg0UFp9%Nyi2WGrb*Pzk4YItd)RBm6#Kuf+TDn8$Mwg1VFp9Oyi3XHrb(QAk4ZJtd)SCm6#Lvf+UEo8$Nxh1VGqaOzj3XHsc(QAl5ZJue-SCn7!Lvg0UEo9%Nxh2WGqb*Pzj4YIsc)RBl5#Kue-TDn7!Mwg0VFp9%Oyi2WHrb*PAk4YItd)RCm6#Kvf+TDo8$Mwh1VFpaOyi3XHrc(QAk5ZJtd-SCm6!Lvf+UEo8%Nxh1WGqaPzj3XIsc(QBl5ZJue-SDn7!Lwg0UEp9%Nxi2WGqb*Pzk4YIsd)RBl6#Kue+TDn7$Mwg0VFp9Oyi2XHrb*QAk4YJtd)RCm6#Lvf+TEo8$Mxh1VFqaOyj3XHrc(QAl5ZJte-SCm7!Lvf0UEo8%Nxh2WGqa*Pzj3YIsc(RBl5ZKue-SDn7!Mwg0UFp9%Nyi2WGrb*Pzk4YItd)RBm6#Kuf+TDn8$Mwg1VFp9Oyi3XHrb(QAk4ZJtd)SCm6#Lvf+UEo8$Nxh1VGqaOzj3XHsc(QAl5ZJue-SCn7!Lvg0UEo9%Nxh2WGqb*Pzj4YIsc)RBl5#Kue-TDn7!Mwg0VFpc)RBl5#Kue-TDn7!Mwg0VFp9%Oyi2WHrb*PAk4YItd)RCm6#Kvf+TDo8$Mwh1VFpaOyi3XHrc(QAk5ZJtd-SCm6!Lvf+UEo8%Nxh1WGqaPzj3XIsc(QBl5ZJue-SDn7!Lwg0UEp9%Nxi2WGqb*Pzk4YIsd)RBl6#Kue+TDn7$Mwg0VFp9Oyi2XHrb*QAk4YJtd)RCm6#Lvf+TEo8$Mxh1VFqaOyj3XHrc(QAl5ZJte-SCm7!Lvf0UEo8%Nxh2WGqa*Pzj3YIsc(RBl5ZKue-SDn7!Mwg0UFp9%Nyi2WGrb*Pzk4YItd)RBm6#Kuf+TDn8$Mwg1VFp9Oyi3XHrb(QAk4ZJtd)SCm6#Lvf+UEo8$Nxh1VGqaOzj3XHsc(QAl5ZJue-SCn7!Lvg0UEo9%Nxh2WGqb*Pzj4YIsc)RBl5#Kue-TDn7!Mwg0VFp9%Oyi2WHrb*PAk4YItd)RCm6#Kvf+TDo8$Mwh1VFpaOyi3XHrc(QAk5ZJtd-SCm6!Lvf+UEo8%Nxh1WGqaPzj3XIsc(QBl5ZKuk5Z