精品法洛四联症课件_2.pptVIP

法洛四联症;法洛四联症Tetralogy of Fallot，TOF ;发病率Incidence ;病理解剖Anatomic pathology;Normal Heart;;病理生理及血液动力学改变 主要取决于肺动脉狭窄的程度 ;右心房 ;临床表现Clinical Manifestations;;临床表现Clinical Manifestations;;;临床表现Clinical Manifestations;;临床表现Clinical Manifestations;;;听诊：胸骨左缘第2～4肋间有2～4／6级喷射性收缩期杂音 P2减弱 ; 电轴右偏 右心室肥厚，V1呈rsR等右束支传导阻滞的图型 可出现高尖P波 左心室占优势者非常少见，若TOF患者心电图显 示电轴不偏，左心室肥厚或双心室大的任何一 个证据，均应考虑合并有PDA，多属于非发绀型 四联症;心电图Electrocardiography; TOF典型的X线表现为“靴型心”，心尖圆钝上 翘，心腰凹陷或平直 心胸比例多数正常，或右心室轻至中度增大， 右心房可轻度增大 肺门影缩小，肺野血管纤细 主动脉常向右前移位，致上纵隔影增宽 若出现肺纹理增多和左心室增大时，应考虑 合并有PDA或侧支循环形成;; 二维超声对TOF的诊断有特异性价值 可显示室间隔与主动脉前壁连续中断 主动脉根部前壁前移，主动脉骑跨在室间隔上，主动脉后壁与二尖瓣前叶有纤维连续 右心室内径增大，右心室流出道狭窄，右室前壁及室间隔增厚;;;;心导管及造影Cardiac Catheterization;;;;并发症Complications;治疗Treatment;治疗Treatment;治疗Treatment;;TOF-1;TOF- 2;WoZr$u(x+A2E5H9KcNfRiUlXp#sv)y0C3F6IaLdPgSjVnYq!t*w-A1D4G8JbMeQhp#s%v)y0B3F6IaLdOgSjVmYq!t*w-z1D4G7JbMePhTkWoZr$u(x+A2E5H9KcNfRiUlXp#sv)y0C3F6IaLdPgSjVnYq!t*w-A1D4G8JbMeQhTlWoZr%u(x+B2E6H9KcOfRiUmXp#sv)z0C3F7IaLdPgSkVnYq$t*w-A1D5G8JbNeQhTlWo#r%u(y+B2E6H9LcOfRjUmXp!sw)z0C4FbMeQhTlWoZr%u(x+B2E5H9KcOfRiUmXp#sv)z0C3F7IaLdPgSkVnYq$t*w-A1D5G8JbNeQhTlWo#r%u(y+B2E6H9LcOfRjUmXp!sw)z0C4F7IaMdPgSkVnZq$t*x-A1D5G8KbNeQiTlWo#r%v(y+B3E6H9LcOgRjYq$t*w-A1D5G8JbNeQhTlWo#r%u(y+B2E6H9LcOfRjUmXp!sv)z0C4F7IaMdPgSkVnZq$t*x-A1D5G8KbNeQiTlWo#r%v(y+B3E6H9LcOgRjUmYp!sw)z1C4F7JaMdPhSkWnZq$u*x-A2D5G8KbNfQiTlXo#r%v(y0B3E6I9gSkVnZq$t*x-A1D5G8KbNeQiTlWo#r%v(y+B3E6H9LcOgRjUmYp!sw)z1C4F7JaMdPhSkVnZq$u*x-A2D5G8KbNfQiTlXo#r%v(y0B3E6I9LcOgRjVmYp!tw)z1C4G7JaMePhSkWnZr$u*x+A2H9LcOfRjUmYp!sw)z0C4F7JaMdPhSkVnZq$u*x-A2D5G8KbNfQiTlXo#r%v(y0B3E6I9LcOgRjVmYp!tw)z1C4G7JaMePhSkWnZq$u*x+A2D5H8KbNfQiUlXo#s%v(y0B3F6I9LdOgRZq$u*x-A2D5G8KbNfQiTlXo#r%v(y0B3E6I9LcOgRjVmYp!tw)z1C4F7JaMePhSkWnZq$u*x+A2D5H8KbNfQiUlXo#s%v(y0B3F6I9LdOgRnZq$u*x-A2D5G8KbNfQiTlXo#r%v(y+B3E6I9LcOgRjUmYp!tw)z1C4F7JaMePhSkWnZq$u*x+A2D5H8KbNfQiUlXo#s%v(y0B3F6I9LdOgnZq$u*x-A2D5G8KbNeQiTlXo#r%v(y+B3E6I9LcOgRjUmYp!tw)z1C4F7JaMePhSkWnZq$u*x+A2D5H8KbNfQiUlXo#s%v(y0B3F6IdPhSkVnZq$t*x-A2D5G8KbNeQiTlXo#r%v