The congenital heart attack is period for embryo cardiovascular develop an excrescent but causable bnormal sexually transmitted disease a disease, clinical top brief name is”first secret concern”, is the child familiar heart disease.The accurate cause of disease isn’t quite know, but the recent years research think with genetics especially to infect(such as nettle rash, bow body disease) inside chromosome abnormality(21-3 bodies be comprehensive to advertise for, 13 and 15-3 bodies comprehensive advertise for), temple, contact project the line, nourishment lack(if the folic acid lack), medicine influence(if use an anti-cancer medicine, A sugar rather), metabolism the chronic anoxia in mess disease(diabetes, Gao Gai4 Xie3’s disease, benzene C sour Tong urine disease) and womb of chronic disease etc. relevant.Generally think the influence of any above-mentioned factor all can influence heart embryo in the embryo develop the process of the 3-8th week of growth, can immediately make the heart some part of growth deadlock or growth abnormality result in the congenital heart attack of various type.Each kind of outbreak rate of heart attack one by one in order shut for the room partition defection and damage, artery pipe and the room separate the defection and damage, method joy surname four allied diseases.
Lend support to a check:1.the super voice move diagram, 2.electrocardiogram, 3.X line check, 4.heart pipe check.
A, the atrium partition defection and damage ASD
[Diagnose important point]
1, symptom:The defection and damage diameter is small and the blood reposition of redundant personnel quantity the young can all have no symptom.The defection and damage is rightwards big and left the reposition of redundant personnel quantity be many will influence to suffer from son growth growth, appear tired, many sweat, emaciated, activity behind annoy Cu, easily suffered from a breath way an infection.
2, the body advertise for:The defection and damage is small reposition of redundant personnel quantity the young be only to smell in the breastbone left good luck and the Ⅱ class or so jet constringency expect a miscellaneous sound, the lung artery petal area the disloyalty of heart sound(P2) split up.The defection and damage the big can have before the heart the area swell up, the heart point pulsates Mi to spread, the breastbone left good luck 3 can smell and the Ⅱ -Ⅲ class jet constringency expect a miscellaneous sound, the lung artery petal area the disloyalty of heart sound Kang enter and fix sex abruption.Left rightwards when the reposition of redundant personnel measure more and greatly, the breastbone left good luck can smell under and comfortable piece middle the Long Long kind miscellaneous sound.
[Cure a principle]
1.the room separate defection and damage natural more with of the possibility be small and the past proper surgical operation cure.
2.deliver bore defection and damage to expect symptom at the infant at first light, the child expects to be easy to take place lung artery high pressure.Repair surgical operation generally before school age.(4-5 years old)Merge two sharp petals returns to flow medicine to handle an invalid, should carry on a surgical operation treatment.The completeness building room passage also belongs to the film mat defection and damage scope inside the heart, suffer from son to often have a breath way the infection, the lung artery high pressure or mental exertion to crock up, can the surgical operation repairs in 1 year oldly.
3.after hair the bore defection and damage reposition of redundant personnel quantity be very small again have no lung artery high pressure, have no surgical operation to advertise for.A handful of defection and damage reposition of redundant personnel have great capacity or mental exertion happen to crock up, the medicine treatment has another effectively, mostly can postpone to make repair Shu at the age of 4-5, this age child to surgical operation stroke of acceptance dint younger infant is old.
4.the defection and damage pipe of the atrium partition get involved close Shu:From 1972 start try out after pipe getting involved to carry on ASD close Shu, applying a single umbrella method at the earliest stage, improve for the double an umbrella method, the recent years again improvement equips close ASD for the button double dish.A little bit local hospitals have already started try out.
Two, the ventricles partition defection and damage VSD
[Diagnose important point]
1, symptom:The small scaled defection and damage can have no symptom;The medium-sized defection and damage easily suffered from a breath way infection, accidentally can take place mental exertion to crock up;The large defection and damage often again and again suffers from breath way infection and pneumonia and suffer from a son growth growth bad, emaciated and tired, activity behind annoy nasty, easy mental exertion happen to crock up.
2, the body advertise for:The small scaled defection and damage can be left in the breastbone to be like 3 and 4 to smell and rough whole constringencieses of the Ⅲ -Ⅳ class expect a miscellaneous sound, lung artery petal the second sound(P2) not the Kang enter, can Men and tremor.Medium-sized the defection and damage is left before the heart the area can swell up, the breastbone is left to be like 3 and 4 and can smell and the Ⅲ -Ⅳ class rough whole constringencieses expect a miscellaneous sound, lung artery petal the second sound(P2) not the Kang enter, can Men and tremor.Large room partition’s defection and damage the area swells up obviously before the heart, the heart point pulsates Mi to spread, lock 4 and 5 outside the bone centerline, the breastbone is left to be like 3 and 4 and can smell and Ⅱ -Ⅳ class rough of the whole constringencieses expect a miscellaneous sound, much can Men and tremor, the heart sharp department can smell and comfortable piece middle the Long Long kind miscellaneous sound, P2 Kangs enter obviously.
[Cure a principle]
1.defection and damage the small the child grow growth have another normally and generally can temporary need not surgical operation.Among them, 20%-50% can automatically shut to match with the age growth, the small defection and damage shuts to match rate Gao, big of the defection and damage shut to match a rate low, automatically shut to match to much take place at 5 years old in.This type of suffer from son should notice to prevent°from the germ film inside the heart burning.
2.medium-large VSD such as left rightwards the reposition of redundant personnel one who measure to more and greatly have lung artery high pressure should consider at 1 year old-the 1-year-old half make repair surgical operation.Such as the lung artery press normally or the light degree go up, lung blood quantity(Qp) is whole body blood quantity(Qs) of 200%, generally carry on surgical operation at the age of 4-6.
3.the large VSD easily takes place Chong guts mental exertion to crock up and again and again breathes an infection, suffering from a son growth growth can be subjected to obvious influence and crock up treatment such as the anti- mental exertion invalid, any age all can consider surgical operation.
4.although have lung artery the high pressure have no right all can make repair Shu toward the left reposition of redundant personnel, the death rate be higher.Once take place right to the left reposition of redundant personnel, clinical up appear green purple, then explain to have already developped to become the moxa Sen Man space a surname comprehensive advertise for, is a surgical operation taboo disease, suffer from the son already painful lose surgical operation opportune moment.
5.Be located on the room top Mao l~the VSD with 2_ ks, the easy merger aorta petal takes off to hang, and have no shut to match by oneself of possibility, should as early as possible make repair Shu.
6.the heart pipe get involved close VSD:Few because of mature experience, abroad’s try out may have a superior flight of steps leading to a palace hall at the heart sharp department the muscle defection and damage.
Three, artery pipe the end shut PDA
[Diagnose important point]
1, symptom:The pipe caliber thin, clinical can have no symptom.The pipe is thick but reposition of redundant personnel quantity to compare with the big, , suffer from son to have heart palpitates, spirit nasty, tired, many sweat etc. symptom.
2, check-up:The left side breastbone can swell up.The breastbone left good luck 2 continuous sex machine kind miscellaneous sound(the whole constringency expect with comfortable Zhang Qi2) that can smell loud and clear coarsenesses to left lock the bottom of the bone and neck conduction.The miscellaneous sound ring place most can Men and tremor.Merge the mental exertion crock up or lung artery high pressure, usually only can hear the constringency expecting a miscellaneous sound.Reposition of redundant personnel quantity to compare with the big, , the heart sharp area can smell and comfortable Long kind miscellaneous sound of Zhang Qi2 Long2.The lung artery petal area the second sound Kang enter, but have another is cover up by the miscellaneous sound.The vein presses to increase breadth, it is thus clear that the nail bed hair thin blood vessel pulsate, there is water blunt vein etc..The lung artery presses to increase Gao Xian3 Zhao ’s the second half body green purple, can have a Chu form to point.
[Cure a principle]
1.surgical operation ligation or cut off artery pipe can go forward a line in the school age, in order to prevent influence child growth growth.If the condition need any age all can carry on surgical operation.
2.the artery pipe of premature infant shut and can use to eliminate inflammation a painful treatment.Head 0.2 ings/ks, like day age<2 day, the 2 and 3th is 0.1 ing/kg, day age 2-7 day, 2 and 3 is 0.2 mgs/kS, >8 day, 2 and 3 is 0.25 mgs/kg.Each 12 small 1, total 3.Vein slow-moving and even drop person.May also use 0.]mg/(kg ·time), total 6 days, medicine total quantity constant, the PDA close rate is 90%, but the former only is 77%.And the former 6 divas relapse the rate as 40% and the latter is 21%.
3.the recent years developped some don’t open the chest surgical operation treatment PDA new therapy, stop artery pipe such as the Rashkind method(miniature spring coil umbrella) or the Partsmann method(special plastics plug).Or the price be expensive or the operation be complicated, the domestic still difficult expansion use.Coil method(miniature spring coil the turn stop artery pipe), operate simple and effective, be easy to expansion
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