CHD先天性心脏病英文课件.ppt

Assistant examinationes Echocardiograph 2D echo: special value in diagnosis TOF Continuity breaks off between ventricular septel and aorta front wall Front wall of aorta root shift forward,aorta overriding on ventricular septel RV enlargement,RV outlet narrowing，RV front wall and ventricular thicken Cardiac Catheterization and angiocardiography right cardiac catheterizationdata of blood oxygen: LVdata of pressure: RV/PA, continuous pressure curves from PA to RVabnormal way: RV to AO,RV to LV RV angiography Complications Cerbral thrombosis(脑血栓):incidence 4％。HCT(血球压积) increased，blood stream slowing blood stickness increased，result in thrombosis Brain abscess(脑脓肿):many happen in senior(2 years old) and adult。It should be considered in TOF with fever,headache, vomit, hypersomnia (嗜睡), convulsion(抽搐), hemiplegy(偏瘫) Infective endocarditis: TOF less pneumonia and HF Treatment Internal medicine treatment Activity is restricted Prevent infection Intake enough water everyday to prevent dehydration(脱水) Prevent inducements of cyanotic spells such as fever, iron deficiency anemia Treatment Prevent and control cyanotic spells： Chest-knee position at once Morphine: 0.1~0.2mg／kg，im，or propranolol: O.1mg／kg iv，injection for 5～10 min prevention: propranolol 1mg／kg·d,oral Treatment Surgery 70% operated once within 1 years old Palliative surgery(姑息性手术 ) should be considered in young baby, serious, poor development of PA branch, hypoplastic LV Differentiation of common CHD types VSD ASD PDA TOF classification L to R shunt R to L shunt sign Murmur position Murmur loundness property thrill P2 L 3-4 L 2-3 L 2 L 2-3 2-5/6 rough SM transmit wide 2-3/6 blowy SMtransmit narrow 2-4/6 continuous machine  transmit wide 2-4/6 spray SM transmit wide yes No yes May be yes hyperfunction Fixed split hyperfunction reduce Differentiation of common CHD types VSD ASD PDA TOF classification L to R shunt R