{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1869","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1869","topicTypeId":null,"topicThemeId":"1029","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":0,"totalPage":0,"totalRow":0},"metaSearch":{"description":"为您提供:儿童先天性心脏病症状_新生儿先天性心脏病症状等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"儿童先天性心脏病症状_新生儿先天性心脏病症状","title":"儿童先天性心脏病症状_新生儿先天性心脏病症状","channels":null},"data":{"list":[{"id":"8487","isDel":0,"createAt":1512023883804,"createBy":"8b39c578b53311e7a3d800163e04584d","createName":"梅油油","updateAt":1526272271642,"updateBy":"8b39c578b53311e7a3d800163e04584d","updateName":"梅油油","userId":"8b39c578b53311e7a3d800163e04584d","title":"先心病的症状主要有哪些","content":"


先天性心脏病是心血管疾病中的一种，先天性心脏病疾病是由于胎儿的心脏在母体内发育有缺陷或者部分发育停顿而导致的畸形。对于先天性心脏病而言，重要的是如何去发现，只有发现了疾病，才谈得上如何去治疗疾病，所以我们来了解一下先心病的相关症状。

 

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一、心衰

 

刚出生的婴儿出现心衰的话通常被认为是一种急症，一般是因为患病儿童有非常严重的心脏缺损造成的。由于肺循环、体循环充血，心脏的血液输出量减少。患病儿童面色灰显得苍白，心跳速度过快，呼吸比较困难，心跳接近两百，而血压通常会比较低。肝脏会变大，但是肝脏外周水中少。可以听到奔马律。

 

二、紫绀

 

多在口唇、鼻尖、手指和脚趾的甲床会比较明显。

 

三、蹲踞

 

通常在剧烈活动之后会出现蹲踞的症状。这样可以增加体循环血管的阻力，从而减少心膈缺损产生的分流，也能够增加静脉血液回流，改善肺部的血液循环。

 

四、杵状指（趾）和红细胞增多症

 

先天性心脏病几乎都会伴有杵状指（趾）和红细胞增多症。这种病症的机理还不是很清楚，但是红细胞增多是由于动脉低血氧而造成的一种生理反应。

 

五、肺动脉高压

 

先天性心脏病通常会造成肺动脉高压，当症状严重时，可能会无法康复，一个的方法就是心肺移植手术，如果到这种程度，患者通常会在四十岁之前死亡。

 

六、发育障碍

 

有先天性心脏病的患病儿童通常发育都会有障碍，比如营养不良、十分瘦弱矮小、发育十分迟缓等。


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轻者无症状，查体时发现，重者可有活动后呼吸困难、紫绀、晕厥等，年长儿可有生长发育迟缓。症状有无与表现还与疾病类型和有无并发症有关。根据血液动力学结合病理生理变化，先天性心脏病的早期症状可发为三类：

  

\"先天性心脏病的早期症状。\"


一、无分流类。左、右两侧无分流，无紫绀，如肺动脉口狭窄，主动脉狭窄，主动脉缩窄，原发性肺动脉扩张，原发性肺动脉高压或右位心等。 　　

  

二、左至右分流类。在左、右心腔或主、肺动脉间有异常通道，左侧压力高于右侧，左侧动脉血通过异常通道进入右侧静脉血中——左向右分流，如心房间隔缺损，心室间隔缺损，动脉导管未闭，主肺动脉隔缺损，部分肺静脉畸形引流，瓦氏窦动脉瘤破入右心。一般无紫绀，若在晚期发生肺动脉高压，有双向或右到左分流时，则出现紫绀，又叫晚期紫绀型。 　　

  

三、右至左分流类。右心腔或肺动脉内压力异常增高，血流通过异常通道流入左心腔或主动脉。一般出生后不久即有紫绀，如法乐氏四联症，法乐氏三联症，三尖瓣闭锁，永存动脉干，大血管借位，艾森曼格氏综合征等。


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\"timg


 先天性心脏病是儿童先天性畸形中最常见的一类，占畸形比例28%左右，很多人听说先天性心脏病基本活不过35岁，这是真的吗？很多患儿父母都会问，先天性心脏病能活多久？先天性心脏病能治好吗？


先天性心脏病能治愈吗？


 对于先天性心脏病，最重要是尽早和及时的治疗。如果先天性心脏病患儿在5岁前就接受正规治疗，也有可能与正常儿童一样生长发育的，及早治疗，治愈的机会就越高。如果选择不治疗，那么最终的结果可能是因为心功能衰竭而死亡。


 如果出现已经出现心功能衰竭的症状，那么治愈的可能性比较低，还有一些比较复杂的先天性心脏病，也是比较难治愈的，比如是大血管转位、单心室畸形、永存动脉干等，手术死亡率就有10%以上。如果治疗不及时，就是到时可以进行手术，也无法治愈。


 随着医学技术的发展，一般的先天性心脏病患者可以通过心脏移植手术或矫正手术治愈，多数患者治疗后，可以恢复正常的生活。所以，对于先天性心脏病，不是想能活多久，而是积极面对，及时治疗。

 

先天性心脏病在临床中有什么表现？


1.经常感冒或呼吸道感染，容易得肺炎。


2.生长发育状态差，身体吸收营养功能差，表现为消瘦和多汗，体质差。


3.先天性婴儿在吸奶时表现为无力或呛咳，呼吸急促。而大一点的孩子会经常感到全身乏力，蹲下来站立后容易晕厥。


4.嘴唇或指甲发紫，这是心脏病十分典型的症状。


5.通过听诊心脏的跳动，可以发现心率不齐或有杂音的现象。


以上就是先天性心脏病治疗和症状表现的相关介绍，希望对大家有所帮助。先天性心脏病是孩子在妈妈子宫内成长时因为某些原因形成了，所以各位准妈妈应该要了解先天性心脏病的病因，保护好自己，也就是保护好腹中的宝宝！

 


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   先天性心脏病是先天性畸形中最为常见的一种，较轻的患儿常无明显症状，查体时可发现，严重的患儿在活动后有晕厥、紫绀、呼吸困难等症状，且先天性心脏病还会影响患儿的正常生长发育。下面找良医网为大家详细介绍先天性心脏病症状的表现症状。

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1、患儿由于受到病情影响，生长发育比同龄人迟缓。这主要是因为体循环流量及血氧供应不足而引起的。具体表现为患儿比同龄人体重轻，且身高也落后于同龄人。

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2、呼吸急促，在婴幼儿时期，如果患儿出现吸允无力、呼吸浅进，吸几口奶水就要停一下，感觉很累，满头大汗，或者在还没有完成吮吸动作却由于气促而不得不放弃，有喘息动作时，家长都应该提高警惕。

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3、紫绀，是复杂性先天性心脏病的重要症状，主要表现为患儿口唇和皮肤等处出现青紫，尤其在活动后或大哭之后，紫绀症状会更加明显。我院专家介绍，新生儿时期出现紫绀很有可能是 性大动脉错位或肺动脉闭锁等引起的；在幼儿六个月～一岁时出现紫绀加重的现象，则很有可能是法乐氏四联症。

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4、反复呼吸道感染或肺炎是最常见的症状，轻症状的患儿会出现呼吸急促、呛咳的症状，还有些表现为哭时声音嘶哑，甚至出现心功能不全的症状。在检查时，可发现患儿心脏杂音。

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5、昏厥，又被称为缺氧性发作。患儿先天性心脏病常常突发紫绀加重、呼吸困难，直至失去知觉。常常在排便、啼哭、哺乳时发生。

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6、水肿是先天性心脏病患儿出现心力衰竭的重要警示。当患儿有以上症状，且出现下肢凹陷性水肿、尿少时，则表示患儿已经出现心力衰竭的症状。

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　　小王夫妇喜添千金,可小宝宝出生后不到一个月,白天哭吵不安,吃奶时总是显得很费力,体重也不见增加。渐渐地脸色变得苍白了,出汗又多,哭声嘶哑,进而小便量减少,眼睑浮肿,呼吸也越来越急促。于是赶紧来到了儿童医院的心脏专科门诊。经医生初步检查,发现宝宝有心脏杂音,且已有心功能不全了,经进一步作心电图、胸部X线摄片及心脏彩色超声检查后,证实宝福患有先天性心脏病(室间隔缺损)。幸亏及时发现,通过一系列强心、利尿、扩血等药物治疗及周到护理,宝宝呼吸逐渐平稳,体重也有所增加,要等观察一段时间后决定是否需要手术治疗。 


　　先天性心脏病种类不少,不同类型表现各一,有的先心病在婴幼儿时期可以没什么症状,生长发育也不受影响,只是偶尔在体格检查时发现有心脏杂音才会被引起重视。这类心脏病早期一般对心功能也不会有什么影响,患儿的身高体重及智力发育基本与正常同龄儿相同。较常见的类型有房间隔缺损、小型室间隔缺损、小型动脉导管未闭及轻度肺动瓣狭窄等。

 
　　还有一类是青紫型先天性心脏病,患儿出生后即可有口唇发紫并伴有气促,容易引起家长注意。但有些患儿早期处于轻度青紫状态,两颊口唇呈暗红色,常常被误认为“血色好”。出现这些现象主要是由于心内畸形,含氧量低的静脉血流入含氧量高的动脉血液系统,导致皮肤粘膜表浅毛细血管内含二氧化碳的血红蛋白含量增高,当达到大于或等于50%克时,则出现肉眼可看到的青紫,而处于临界水平的孩子青紫不太明显,但会有“红得发紫”的感觉,此时一定要引起警惕。某些青紫型先天性心脏病患儿还常常会有特殊体位,在活动时感到疲劳后,喜欢蹲下来休息片刻再站起来活动,医学上称之为蹲踞现象。这些患儿在婴儿期卧床时,即喜采取四肢屈曲的侧卧位,母亲怀抱患婴可发现将下肢屈曲贴近其腹壁,患儿似乎觉得安逸许多。蹲踞一般在患儿下地行走时才会出现,最多见于患有法洛氏四联症(青紫型先天性心脏病的一种)的孩子。 


　　随着先天性心脏病治疗技术的不断发展,绝大多数患儿都能治愈,所以先心病并不可怕,关键在于早期发现合理治疗,若需要应及早手术,就像前面讲到的那个宝宝,要是再迟一步就诊后果将不堪设想。一旦发现有先天性心脏病存在,父母对孩子更要倍加照料,定期去医院随访,在医生的指导下按时服药及其他相应护理,直到患儿得到痊愈。


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　　先天性心脏病(先心病)发病率约1％，估计我国每年新增先心病患儿达15万左右，是小儿最常见的心脏病。对这些患儿，外科手术是传统的治疗方法，已有较丰富的经验和良好治疗效果，但外科手术需开胸和体外循环，对机体损伤较大，有一定手术并发症且留有瘢痕。 


　　近10年来，随着微创介入手术的飞速发展和介入器材设计的日趋合理，先心病的治疗方式正在发生重大转变。介入治疗已经不是外科治疗的补充与替代，对部分有适应证的患者已成为首选的治疗方案。目前先心病介入治疗技术可分为两类：①封堵术类：包括动脉导管未闭(PDA)封堵术、房间隔缺损(AsD)封堵术、室间隔缺损(VSD)封堵术、冠状动脉瘘封堵术、复杂发绀型先天性心脏病侧支循环封堵术等。②扩张术类：包括球囊房间隔造口术、瓣膜成形术(球囊肺动脉瓣成形术、球囊主动脉瓣成形术)及血管成形术(主动脉缩窄血管成形术、肺动脉分支狭窄血管成形术)等。本文就常见的先心病介入治疗简单介绍如下。 
　　 
　　动脉导管未闭(PDA)封堵术 

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　　1967年Porstmann首先报道应用泡沫塑料经导管封堵PDA获得成功。此后不断有新的封堵装置问世，1992年Cambier等报道使用普通弹簧圈封堵直径＜2．5mmPDA，1997年Masura等报道应用Amplatzer蘑菇伞形动脉导管封堵器治疗PDA[1]。上述两种装置操作简便，成功率高，输送鞘管细，前者适用于动脉导管内径＜2．5mm者，后者适用于＞2．5mm者。使用弹簧圈和蘑菇伞形封堵器几乎可治疗各种大小和形状的PDA。由于手术操作简单，安全性好，技术成功率高，并发症少，目前介入治疗已取代外科手术成为PDA首选的治疗方法。

 
　　现在通常认为只要PDA患者未发生艾森曼格氏综合征，均可行封堵治疗。我国1998年引进Amplatzer技术。目前国内外普遍应用的是Amplatzer法及弹簧栓子法。 


　　动脉导管未闭(PDA)封堵术适应证　①Amplatzer法。适应证：左向右分流不合并需外科手术的心脏畸形的PDA；PDA最窄直径≥210 mm；年龄通常≥6个月，体重≥4 kg：外科术后残余分流。提示：≥14mm的PDA，其操作困难，成功率低，并发症多，应慎重。禁忌证：依赖PDA存在的心脏畸形；严重肺动脉高压并已导致右向左分流；败血症，封堵术前1个月内患有严重感染。②弹簧栓子法。适应证：左向右分流不合并需外科手术的心脏畸形的PDA；PDA最窄直径单个Cook栓子≤210 mm：单个pfm栓子≤3mm；年龄通常≥6个月，体重≥4kg；外科术后残余分流。禁忌证：窗型PDA：余同上。 
　　 
　　房间隔缺损(ASD)封堵术 
　　 
　　ASD是常见的先心病之一，其中继发孔缺损约84％。1990年Sideris等使用纽扣式补片装置封堵ASD，其输送鞘管细，可治疗30 m以内的ASD，经多中心应用，成功率约90％，但仍存在操作较复杂、术后残余分流发生率较高等缺点。1998年与以往设计思路不同的新型封堵器Amplatzer双盘型房间隔封堵器用于临床，该装置的“腰部”与ASD的直径相匹配，使封堵器不易发生移位，并降低残余分流发生率，两侧盘状结构在恢复记忆形状后可协助封堵ASD边缘部分，进一步减少残余分流。使用此型封堵器操作简便，且输送鞘管细，目前成为介入治疗ASD首选装置。经中期随访，成功率与外科手术相近，而并发症较少[2]。目前介入治疗方法已很成熟，对有适应证的患者而言，已经成为其首选治疗方案。 


　　房间隔缺损(AsD)封堵术适应证①左向右分流的单纯继发孔ASD(包括多发性缺损)。②继发孔ASD并可介入治疗的其他先心病。③复杂先心病功能矫治术中需留存ASD或心房水平交通，以适应术后血流动力学变化，一旦血流动力学调整完成，需关闭ASD。④年龄＞1岁，体重＞8kg，ASD直径＜34mm，且房间隔最大伸展径比ASD直径大14mm以上，缺损边缘与房室瓣、冠状静脉窦、右上肺静脉开口距离＞4mm。因术后应用肝素或低分子肝素2次／d，口服阿司匹林3～5mg／(kg・d)，疗程4～6个月，故患者应能耐受抗凝治疗。 


　　根据目前国内近4000例统计，技术成功率98％以上，主要并发症有封堵器脱落和心包压塞，死亡率约0．2％。在操作中应特别注意避免自鞘管进入空气，以免引起冠状动脉气栓。一旦发生可吸氧，酌情使用血管扩张剂和阿托品。近年来又推出一种螺旋型Helex房间隔缺损封堵器，疗效有待进一步观察[3]。 
　　 
　　室间隔缺损(VSD)封堵术 
　　 
　　VSD约占先心病的20％～30％。绝大部分VSD发生在膜部及膜周部，膜部及膜周部VSD近邻主动脉瓣、房室瓣及传导束等重要解剖结构，其封堵治疗易引起严重的并发症，因此在很长一段时间内介入治疗遇到了很大的困难。1988年Lock等[4]首次应用Rashkind双面伞关闭VSD，1994年Sideris应用纽扣式补片装置关闭VSD成功，但由于操作复杂、并发症严重而未能推广应用。1999年Thanopoulos应用于ASD的Amplatzer封堵器进行改进后封闭肌部VSD成功，但肌部病例少。2000年镍钛合金膜部VSD封堵器应用于临床，因其具有操作简便、效果可靠、适应证广、安全性高等诸多优点，使VSD的介入治疗步入快速发展的新时代。 


　　VSD封堵术适应证　①左向右分流的膜周部或肌部VSD，直径＜14mm，无主动脉瓣脱垂及中度以上主动脉瓣反流，无梗阻性肺动脉高压及其他需外科手术治疗疾病。伴室间隔膜部瘤和(或)轻度三尖瓣反流者可选择。②外科手术后残留VSD。③年龄＞1岁，体重＞10 kg，缺损上缘距主动脉瓣(右冠瓣)＞1mm。禁忌证有活动性心内膜炎或引起菌血症的其他感染；心内有赘生物；导管插入途径有血栓形成；血管过细，输送鞘管难以插入；缺损解剖位置不良，封堵器置入后影响瓣膜功能等。膜周部ASD封堵术国内外已开展近千例，技术成功率97．5％，并发症发生率2．7％，主要有心脏传导阻滞、封堵器脱落、瓣膜反流等。 
　　 
　　经皮球囊瓣膜成形术 
　　 
　　经皮球囊肺动脉瓣成形术(PBPV)1982年由Kan等[5]首先报道。20世纪80年代中期开始在我国各大城市陆续开展，现已成为取代外科手术、治疗肺动脉瓣狭窄(PS)首选方法，经长期随访，疗效优良率达99％[6]。目前，这



一疗法已取代外科手术成为治疗肺动脉瓣狭窄首选方法。可使用单球囊、双球囊或双叶球囊进行PBPV。双球囊扩张术主要用于年长儿或成人肺动脉瓣环直径较大，单一球囊难以达到疗效者；肺动脉瓣狭窄严重者，为保证安全，可先插入一根较小球囊，再行双球囊扩张；年龄小、血管细、单球囊插入困难者，可选两根较小球囊。 


　　PBPV适应证明确适应证：典型肺动脉瓣狭窄，心输出量正常时经心导管检查跨肺动脉瓣压差≥50mmHg。最佳年龄2～4岁，其余各年龄均可进行。相对适应证：①典型肺动脉瓣狭窄，心电图示右室大，右室造影示肺动脉扩张、射流征存在，但经心导管检查35mmHg≤跨肺动脉瓣压差＜50mm Hg者。②重症新生儿肺动脉瓣狭窄。③重症肺动脉瓣狭窄伴心房水平右向左分流。④轻、中度发育不良型肺动脉瓣狭窄。⑤典型肺动脉瓣狭窄伴有动脉导管未闭或房间隔缺损等先心病，可同时进行介入治疗者。 


　　经皮球囊主动脉瓣成形术(PBAV)　1983年Lababidi首先用单球囊治疗主动脉瓣狭窄，其适应证为左室与主动脉压力差≥50mmHg、非瓣膜发育不良型、无明显主动脉瓣反流主动脉瓣狭窄。可用单球囊或双球囊，所选球囊一般等于或稍小于主动脉瓣瓣环直径，以免造成主动脉瓣反流。 


　　PBAV适应证　明确适应证：典型主动脉瓣狭窄，心输出量正常时经导管检查跨主动脉瓣压差≥50 mm Hg，无或仅轻度主动脉瓣反流。相对适应证：①重症新生儿主动脉瓣狭窄。②隔膜型主动脉瓣下狭窄。 
　　 
　　展望 
　　 
　　先心病的介入治疗真正成为介入心脏病学一个朝气蓬勃的领域。目前PDA、ASD、VSD等介入治疗已逐渐取代外科手术成为治疗的主流，同时随着介入器材和技术的成熟，先心病的治疗策略正在改变，对于复杂或重症先心病，介入和外科手术镶嵌治疗(hybrid approach)也逐渐成为趋势[7]。多种介入治疗技术，如球囊房间隔造口术(BAS)、瓣膜或血管内球囊成形或支架植入术、侧支血管栓塞术等，在一些重症或复杂先心病的治疗中具有重要临床应用价值。随着技术的成熟和器械的国产化，将能更好地推进先天性心脏病介入治疗的发展，使广大患者受益。 


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　　婴儿先天性心脏病主要症状有： 


　　1、出生后即刻或生后逐渐出现青紫，在口唇、指(趾)甲、鼻尖最明显 
　　2、体检发现心脏有杂音 
　　3、生长发育缓慢 
　　4、吃奶时吸吮无力、吃吃停停、喂奶困难，体重不增 
　　5、平时易反复患呼吸道感染 
　　

        青紫与心脏杂音等症状经常在宝宝出生后体检时，被医生所发现。家长在日常生活中应该多留心观察，一旦发现有以上类似症状或其他异常表现，就必须提高警惕，及时到医院做进一步的检查。 

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