→ wangea:謝謝囉 06/22 20:21
※ 引述《egg7567 (下面的克羅馬提)》之銘言：
: 就是在考古題裡面
: 18頁48題 解說VSD才容易併發感染性心內膜炎
: 但是課本在提VSD的時候也有提到TOF的VSD(移位型)
: 22頁20題的解釋又覺得TOF會容易併發心內膜炎(所以才要預防?)
: 所以哪題是對的呢??????
: 1.TOF有VSD，所以容易併發感染性心內膜炎，且因為是R to L shunt
: 所以較不容易出現CHF?
: 2.VSD是L to R shunt跟TOF不一樣，所以TOF不容易併發感染性心內膜炎?
: 而TOF不治療的話易引起CHF?
: 到底是哪個呢@@ 鬥雞?
剛剛查了一下加州大學的兒童醫學部
裡面寫到
A number of preexisting conditions increase a child's risk of developing
endocarditis, including:
1. Congenital heart disease, such as aortic coarctation, Tetralogy of Fallot
and transposition of the great arteries
2. Rheumatic heart disease
3. Cardiac valve anomalies
網址:
http://www.ucsfhealth.org/childrens/medical_services/heart_center/acquired/conditions/endo/signs.html
還有一份期刊
Results.— Follow-up data were obtained from 88% of this cohort of 3860
individuals through 1993. At 25 years after surgery, the cumulative incidence
of infective endocarditis was 1.3% for tetralogy of Fallot, 2.7% for isolated
ventricular septal defect, 3.5% for coarctation of the aorta, 13.3% for
valvular aortic stenosis, and 2.8% for primum atrial septal defect.
網址:http://jama.ama-assn.org/cgi/content/full/279/8/599
所以我覺得宗澤的第一個說法比較對~
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