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患儿,男,19个月,体重10kg。发现心脏杂音1年。患儿平素易患呼吸道感染,反复肺炎,心衰,多次住院治疗。入院时查体:呼吸25次/分,心率110次/分,律整,左侧第3～4肋间闻及收缩期杂音,P_2亢进,震颤(±),腹软,肝脾不大,四肢活动自如。胸片示:肺血增多,全心大,心胸比为0.64,肺动脉段明显突出。心电图示:窦性心律,左右室肥大。心脏超声:先天性心脏病,室间隔缺损(VSD),房间隔缺损(ASD),动脉导管未闭(PDA),肺动脉高压(PH)重,VSD双向分流,以左向右分流为主。入院后诊断为先天性心脏病VSD+ASD+PDA+PH(重)。完善术前各项准备后在体外循环下行VSD、ASD修补术,前平行循环时心包内PDA结扎术。术中见PA∶AO≈1∶2,全心扩大呈球形,修补VSD,VSD
Children, male, 19 months, weight 10kg. Heart murmur 1 year. Children generally susceptible to respiratory infections, repeated pneumonia, heart failure, multiple hospitalizations. Admission examination: breathing 25 beats / min, heart rate 110 beats / min, the whole law, the left 3 to 4 intercostal smell and systolic murmur, P 2 hyperthyroidism, tremor (±) Extremity activities freely. Chest X-ray showed: increased lung blood, whole-hearted, heart-chest ratio was 0.64, pulmonary artery was significantly prominent. ECG shows: sinus rhythm, left ventricular hypertrophy. Echocardiography: Congenital heart disease, ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), pulmonary hypertension (PH) and bilateral VSD shunt. After admission diagnosed as congenital heart disease VSD + ASD + PDA + PH (weight). Perfecting the preparation of preoperative descending in vitro VSD, ASD repair, before the parallel circulation within the pericardial PDA ligation. See surgery PA: AO ≈ 1: 2, expand the ball was spherical, repair VSD, VSD