论文部分内容阅读
患儿男,7岁。口唇发绀、喜蹲踞伴活动后心慌、气促、呼吸困难2年,加重6 d就诊。体格检查:各指、趾均呈杵状,口唇紫绀,心、肺听诊无明显异常。心电图检查提示正常。实验室检查:血红蛋白160 g/L。X线检查:肺血减少,左心室增大。经胸超声检查:左房内径27 mm,左室内径47 mm,右心大小正常。上腔静脉内径约17 mm,由左右头臂干汇合而成,上、下腔静脉汇入右房。左房右后下部见一管状结构与之相通(右下肺静脉),内径约20mm(图1),见红色血流信号进入左房,Vmax=1.62 cm/s,双峰频谱,Vs>Vd;右上肺静脉显示不清,左肺静脉内径正常。肺动脉右支内径22 mm,肺动脉左支起始部显示清,内径约7～8 mm,远端模糊。超声提示:(1)右下肺静脉内径增宽,右下肺动静脉瘘所致?建议进一步检查。(2)肺动脉右支增
Children male, 7 years old. Lips cyanosis, hi squat with activity after palpitation, shortness of breath, difficulty breathing for 2 years, increased 6 d treatment. Physical examination: each finger, toe were clubbed, cyanotic lips, heart, lung auscultation no obvious abnormalities. ECG check prompts normal. Laboratory tests: hemoglobin 160 g / L. X-ray examination: reduced lung blood, left ventricular enlargement. Transthoracic ultrasound: left atrial diameter 27 mm, left ventricular diameter 47 mm, right heart size was normal. The diameter of the superior vena cava is about 17 mm, which is made up of left and right brachiocephalic stems. The superior vena cava and inferior vena cava merge into the right atrium. The left atrium right lower posterior see a tubular structure with the same (right lower pulmonary vein) diameter of about 20mm (see Figure 1), see the red blood flow signal into the left atrium, Vmax = 1.62 cm / s, bimodal spectrum, Vs> Vd; Right upper pulmonary vein is not clear, the left pulmonary vein diameter is normal. The diameter of the right branch of pulmonary artery was 22 mm. The beginning of the left branch of the pulmonary artery showed a clear, inner diameter of about 7 ~ 8 mm, distal blur. Ultrasound Tip: (1) broadening the right lower pulmonary vein diameter, right lower pulmonary arteriovenous fistula? Recommended further examination. (2) right branch of pulmonary artery increased