肌部室间隔缺损.docVIP

　 肌部室间隔缺损 解放军总医院超声科? 柴 亮* 男，15岁，自幼活动后胸闷，加重1个月。患者于自幼易感冒，口唇稍有青紫，有活动后蹲距现象，剧烈活动不能耐受。自幼发育与同龄人相似，无头痛、头晕，无胸痛、晕厥等症状。近1月患者出现活动后胸闷明显，无咳嗽、咯痰，在当地医院检查，诊断为“先天性心脏病，室间隔缺损，肺动脉高压”。 超声所见： 右房增大，右室壁增厚。室间隔平直，左室短轴呈D形。肺动脉内径增宽。室间隔肌部连续性中断约20mm，见双向分流，左向右分流速度：Vmax=1.6m/s，△Pmax=10mmHg。舒张期肺动脉瓣膨隆，M型显示a凹变浅，过肺动脉瓣血流速度：Vmax=1.1m/s，△Pmax=5mmHg，频谱形态呈拳指样改变。收缩期三尖瓣见少-中量反流：Vmax=4.8m/s，△Pmax=92mmHg。 胸骨旁四腔切面显示，室间隔肌部连续性中断 CDFI缺损处右向左分流 胸骨旁左室长轴切面显示，室间隔肌部连续性中断 连续多谱勒录得三尖瓣高速反流频谱 超声诊断： 先天性心脏病： 1、肌部室间隔缺损，双向分流 2、右房增大，右室壁增厚 3、三尖瓣少-中量反流 4、肺动脉增宽，肺动脉压力重度增高 *在读研究生 返回 and work. Many classes established the duty monitor system, let every students have class member services and for the class the opportunity to work, this is not a fixed position of the monitor system of rotation, which not only can let the monitor on duty in a days work for class service work, also can let students know more of the solution in the class, every student can learn. And the class cadre conference held regularly. Pay attention to class and major incidents in the recent, Concerned about the class need to help students and make the class committee work plan and the new division.A good class of 4..Each class in the formulation of the goal, the class of the Convention at the same time, pay more attention to the class a good class construction work class. The class construction is the pillar industry of class education work, to perform the correct public opinion guide guide, schools, teachers education intent can be more smoothly issued, strict execution. Discipline, clean environment, learning atmosphere, most students with emotional attachment and collective identity, and consciously safeguard the collective honor and so on. We must first establish a collective concept, the formation of we are the best, and I win glory for the class collective concept, then do the selection of class cadres Appointment work. Finally, we must adhere to the positive guidance, set up the correct example in the class.5 class warm a