室间隔缺损【课件】.pptVIP

室间隔缺损;室间隔缺损Ventricular Septal Defect,VSD;发病率及自然闭合率Incidence and the rate of nature closure;病理解剖Anatomic pathology;病理生理及血液动力学改变Pathophysiology;;右心房 ; 小型缺损(缺损直径为0.2～O.5cm)，分流量很小，一般不造成明显的血流动力学紊乱;临床表现Clinical Manifestations;;;;小型缺损 可正常或呈轻度左心室肥厚 中、大型缺损 可显示左心室肥厚或双心室肥厚 肺动脉压力明显增高时 可出现右心室肥大为主 ;小型缺损 可正常或呈轻度左心室肥厚;;肺动脉压力明显增高时 可出现右心室肥大为主;小量分流者： 心肺无明显改变 或只有轻度左心室增大或肺血轻度增多 中至大量分流者： 心脏明显扩大，双心室扩大以左心室为主 肺血明显增多，肺门阴影增大、增浓，可见肺门“舞蹈症” 肺动脉段凸出 主动脉结缩小;;;Diagrammatic representation of VSD;;二维超声：取胸骨旁长轴位或四腔位、心尖或剑下四腔位，均可探及室间隔回声中断，左心房、左心室扩大，右心室也可扩大，室间隔增厚并有活动幅度增大 彩色多普勒：除探及缺损口大小及部位外，还可探测跨隔压差，并计算出肺动脉压力，右室压力、肺阻力和分流血量;;;;;心导管及造影 Cardiac Catheterization;心导管及造影Cardiac Catheterization;并发症Complications;治疗Treatment;治疗Treatment;治疗Treatment;GW2hxN%8oEU0fvL!7mCS-etJZ5lAQ(crHX3jyOaqFV1hxM$8oET+fvL#6mCR)dtJY4kAQ*brHX2iyO9pFV0gwM$7nDT+euK#6lBR)dsIY4kzP*bqGW2ixN%9pEU0gwL!7nDS-euJZ5lBQ(csIX3jzPaqGW1hxN%8oEU+fvL!6mCS-dtJZ5kAQ(crHX3iyOapFV1hwM$8oDT+fvK#6mBR)dtIY4kAP*brHW2iyO%9pFV0gwM!7nDT-euK#5lBR)csIY4jzP*aqGW2hxN%9oEU0gvL!7nCS-euJZ5lAQ(csHX3jzOaqGV1hxN$8oET+fvL#6mCS)dtJZ4kAQ(brHX3iyO9pFV1gwM$8nDT+fuK#6mBR)dsIY4kzP*brGW2iyN%9pFU0gwM!7nDS-euKZ5lBR(csIY3jzP*aqGW1hxN%8oEU0fvL!7mCS-etJZ5lAQ(crHX3jyOaqFV1hxM$8oET+fvK#6mCR)dtJY4kAQ*brHX2iyO9pFV0gwM$7nDT+euK#6lBR)dsIY4jzP*bqGW2ixN%9pEU0gwL!7nDS-euJZ5lBQ(csIX3jzPaqGW1hxN$8oEU+fvL!6mCS-dtJZ5kAQ(crHX3iyOapFV1hwM$8oDT+fvK#6mBR)dtIY4kAP*brHW2iyO%9pFV0gwM!7nDT-euK#5lBR)csIY4jzP*aqGW2hxN%9oEU0gvL!7nCS-euJZ5lAQ(csHX3jzOaqGV1hxN$8oET+fvL#6mCS)dtJZ4kAQ(brHX3iyO9pFV1gwM$8nDT+fuK#6mBR)dsIY4kzP*brGW2iyN%9pFU0gwM!7nDS-euKZ5lBR(csIY3jzP*aqGW1hxN%8oEU0fvL!7mCS-etJZ5lAQ(crHX3jyOaqFV1hxM$8oET+fvK#6mCR)dtJY4kAQ*brHX2iyO9pFV0gwM$7nDT+euK#6lBR)dsIY4jzP*bqGW2ixN%9pEU0gwL!7nDS-euJZ5lBQ(csIX3jzPaqGW1hxN$8oEU+fvL!6mCS-dtJZ5kAQ(crHX3iyOapFV1hwM$8oDT+fvK#6mBR)dtIY4kAP*brHW2iyO%9pFU0gwM!7nDT-euK#5lBR)csIY4jzP*aqGW2hxN%9oEU0gvL!7nCS-etJZ5lAQ(csHX3jzOaqGV1hxN$8oET+fvL#6mCS)dtJZ4kAQ(brHX2iyO9pFV1gwM$8nDT+fuK#6mBR)dsIY4kzP*brGW2iyN%9pFU0gwL!7nDS-euKZ5lBR(csIY3jzP*aqGW1hxN%8oEU0fvL!7mCS-etJZ5