i****o
发帖数: 30 | 1 【 以下文字转载自 Medicine 讨论区 】
发信人: iaiayo (iaiayo), 信区: Medicine
标 题: 新生儿肺动脉瓣膜狭窄求助 pulmonary valve stenosis
发信站: BBS 未名空间站 (Fri Dec 25 21:01:51 2015, 美东)
大家圣诞节快乐！我的宝宝11/1/2015出生。他一出生医生发现他哭得费劲，马上住进
NICU，医生很快发现他心脏有问题：肺动脉狭窄。
第一次心脏echo结果11/2/2015 3:02:10 AM
PULMONARY VALVE:
The pulmonary valve is thickened and is doming. There is critically severe
pulmonary valve stenosis. The maximum velocity across the pulmonic valve is
3.89 m/s and the peak instantaneous gradient is 60.6 mmHg. The mean gradient
across the pulmonic valve is 36.9 mmHg. There is trivial pulmonary valve
regurgitation.
然后马上做了球囊扩张的手术。在医院住了13天后回家。这是出院前一天的echo结果11
/12/2015
PULMONARY VALVE:
There is mild pulmonary valve stenosis. The maximum velocity across the
pulmonic valve is 2.6 m/s and the peak instantaneous gradient is 28 mmHg.
There is mild pulmonary valve regurgitation. There is mild residual
regurgitation following pulmonary valve intervention. There is mild residual
stenosis following pulmonary valve intervention. Limited pulmonary valve
excursion. As previously noted, the pulmonary valve annulus measured about 5
mm in diameter, but the effective orifice measures about 2 mm in diameter.
第一次复查11/25/2015， 发现有瓣下狭窄subvalvar stenosis
PULMONARY VALVE:
There is mild pulmonary valve stenosis. There is no pulmonary valve
regurgitation. There is subvalvar and valvar pulmonary stenosis. Dynamic
right ventricular outflow tract obstruction from hypertrophied muscle
bundles with ~16-20 mmHg peak gradient. The pulmonary valve leaflets are
thickened with limited excursion as previously described with liley an
additional ~20 mmHg step-up. By CW Doppler the gradients across the
subvalvar and the valve are 41 mmHg peak and 22 mmHg mean.
第二次复查12/18/2015，发现压力差又增加到重度
PULMONARY VALVE:
There is moderate pulmonary valve stenosis. The pulmonary valve annulus
dimension is 0.49 cm (Z = -3.07 ). There is no pulmonary valve regurgitation
. There is subvalvar (~20 mm Hg) and valvar pulmonary stenosis. The
pulmonary valve leaflets are thickened. With CW Doppler, total gradient
across the subvalvar and valvar area 73 mmHg peak and 36 mmHg mean.
两次复查发现stenosis越来越严重。医生说很可能就要做开胸手术了。请求大家帮帮忙
。我们宝宝这样有可能自己恢复到轻度狭窄么？如果不能，还可以再做catherization
的球囊扩张术么？我很害怕他需要做开胸手术。
另外他第一次检查肺动脉瓣环是0.7cm，第二次是0.6cm，后面很多次都是0.5cm了。他
的肺动脉瓣膜比较厚，说开口“the pulmonary valve annulus measured about 5 mm
in diameter, but the effective orifice measures about 2 mm in diameter.” 最
后一次是瓣环0.49cm。为什么瓣环还会缩小？医生说瓣环小是没办法改变的，只能开胸
手术可以解决，我真的很担心。恳请大家帮忙，非常感谢。
另外瓣下狭窄subvalvar stenosis有可能自愈吗？医生说这个也只能开胸可以解决。
宝宝现在吃睡都比较好，很乖，不爱哭闹，血氧浓度在92%左右。现在55天，有11斤多
，58厘米。
多谢大家帮忙！
一个心碎的妈妈 | h******e
发帖数: 152 | 2 只能pat pat您
一切听医生的， 该做手术就要做，大部分先心病，不治疗，只能进一步加重。
现在要做的，就是选择相信医生。实在不放心，再咨询下两三个新生儿心脏专科医生，
如果诊疗方案类似，妈妈就不要在犹豫了。 |
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