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患儿男,2岁3个月。出生1月后,入睡时有发鼾声,面及口唇无紫绀。常患上呼吸道感染。至1岁半,入睡时鼾声大,张口呼吸,面及口唇可见明显青紫,夜眠不安,清醒时面色好转。查体:无扁桃体肥大,心前区未闻及杂音,无杵状指趾。先后因支气管肺炎并心衰3次住本科治疗,曾发生呼吸心跳骤停1次。本院多次胸片及心电图提示右房右室肥大。1岁10个月时在外院鼻咽镜检查:腺样体肥大,严重堵塞鼻咽部。来我院拟诊腺样体肥大并肺心病。转同济医院做超声心动图示右室流出道增宽,右室右房增大;右心导管检查加数字减影血管造影,右室右房增大,右室流出道及肺动脉系统无狭窄。肺动脉及其分支、左心室、主动脉显影良好,未发现左向右分流征象,右心室压力正常35/5mmHg;动脉血气分析,pH7.16,
Children male, 2 years and 3 months. After birth in January, there is snoring when falling asleep, face and lips without cyanosis. Often have upper respiratory tract infection. To 1 year and a half, sleep when snoring loud mouth breathing mouth, face and lips visible bruising, sleepless nights, awake look better. Physical examination: no tonsils hypertrophy, precordial no smell and noise, without clubbing toe. Has three times because of bronchial pneumonia and heart failure to live undergraduate treatment, respiratory arrest occurred once cardiac arrest. Multiple chest X-ray and ECG prompted right atrial hypertrophy. 1 year and 10 months at the hospital when the nasopharyngoscopy: adenoid hypertrophy, blocked the nasopharynx. To our hospital to be diagnosed adenoid hypertrophy and pulmonary heart disease. Transient Tongji Hospital do echocardiography right ventricular outflow tract widening, right ventricular right room increased; right heart catheterization plus digital subtraction angiography, right ventricular right atrial enlargement, right ventricular outflow tract and pulmonary artery stenosis. Pulmonary arteries and their branches, left ventricle and aorta were well developed. Left-to-right shunt signs were not found and right ventricular pressure was normal 35 / 5mmHg. Arterial blood gas analysis, pH7.16,