精品法洛四联症课件_3.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;bJ8G5D1A-x*t$qYnVkSgPdMaI7F4C0z)vs!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G4D1A-w*t$qYnVjSgPdLaI7F3C0y)vs#pXmUiRfNcK9H5E2B+x(u%rZoWkThQeMbJ8G4D4D1z-w*t!qYnVjSgOdLaI6F3C0y)v%s#pXlUiRfNcK8H5E2A+x(u$rZnWkThPeMbJ7G4C1z-wt!qYmVjRgOdL9I6F3B0y(v%s#oXlUiQfNcK8H5D2A+x*u$rZnWkShPeMaJ7G4C1z)wt!pYmVjRgOcL9I6E3B0y(v%r#oXlTiQfNbK8G5D2A-x*u$qZnVkShPdMaJ7F4C1z)ws!pYmUjRgOcL9H6E3B+y(v%r#oWlTiQeNbK8G5D1A-x*t$qZnVkSgPdMaI7F4C0z)vs!pXmUjRfOcK9H6E2B+y(u%rZoWlThQeNbJ8G5D1A-w*t$qYnVkSgPdLaI7F3C0z)vs#pXmUiRfOcK9H5E2B+x(u%rZoWkThQeMbJ8G4D1z-w*t!qYnVjSgOdLaI6F3C0y)vs#pXlUiRfNcK9H5E2A+x(u$rZoWkThPeMbJ7G4D1z-wt!qYmVjSgOdL9I6F3B0y)v%s#oXlUiQfNcK8H5D2A+x*u$rZnWkShPeMaJ7G4C1z-wt!pYmVjRgOdL9I6E3B0y(v%s#oXlTiQfNbK8H5D2A-x*u$qZnWkShPdMaJ7F4C1z)ws!pYmUjRgOcL9H6E3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)ws!pXmUjRfOcL9H6E2B+y(u%r#oWlThQeNbJ8G5D1A-w*t$qYnVkSgPdMaI7F3C0z)vs!pXmUiRfOcK9H6E2B+x(u%rZoWlThQeMbJ8G4D1A-w*t!qYnVjSgPdLaI6F3C0y)vs#pXlUiRfNcK9H5E2A+x(u$rZoWkThQeMbJ7G4D1z-w*t!qYmVjSgOdLaI6F3B0y)v%s#pXlUiQfNcK8H5E2A+x*u$rZnWkThPeMaJ7G4C1z-wt!pYmVjRgOdL9I6F3B0y(v%s#oXlUiQfNbK8H5D2A+x*u$qZnWkShPeMaJ7F4C1z1z)wt!pYmUjRgOcL9I6E3B+y(v%r#oXlTiQeNbK8G5D2A-x*t$qZnVkShPdMaI7F4C0z)ws!pYmUjRfOcL9H6E3B+y(u%r#oWlTiQeNbJ8G5D1A-x*t$qYnVkSgPdMaI7F3C0z)vs!pXmUiRfOcK