心脏医院

An atrial septal defect is an opening in the atrial septum, or dividing wall between the two upper chambers of the heart known as the right and left atria. ASD is a congenital (present at birth) heart defect. As the fetus is growing, something occurs to affect heart development during the first 8 weeks of pregnancy, resulting in an ASD.

（人的心脏有4个腔，位于上方的）称为右心房和左心房的两个腔之间（有一个本来应该完整的房间隔，如果）在心房间隔上有一个开口就叫做房间隔缺损。房间隔缺损是一种先天性（出生时就有的）心脏病。在母亲怀孕的第8周，胎儿生长发育的过程中，如果有某种因素影响了心脏的发育，即可形成房间隔缺损。

Normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped out to the body through the aorta.

正常情况下，从全身回来的乏氧血进入右心房，流入右心室，泵入两肺进行氧合。氧合后的富氧血从肺部回到左心房，进入左心室，然后通过主动脉泵出心脏进入全身。

An atrial septal defect allows oxygen-rich (red) blood to pass from the left atrium, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right atrium.

（如有）房间隔缺损，（部分）富氧血即可从左心房通过房间隔缺损进入右心房，与乏氧血在右心房内混合。

An ostium secundum is an opening in the middle of the atrial septum which is the most common type of ASD. Atrial septal defects occur in 5 to 10 percent of all children born with congenital heart disease. For unknown reasons, girls have atrial septal defects twice as often as boys.

最常见的房间隔缺损是继发孔房间隔缺损，开口位于房间隔的中部。先天性心脏病患儿中的5％～10％是房间隔缺损。患有房间隔缺损的女孩是男孩的2倍，原因不明。

What causes an atrial septal defect? 房间隔缺损发生的原因是什么？

The heart is forming during the first 8 weeks of fetal development. It begins as a hollow tube, then partitions within the tube develop that eventually become the septa (or walls) dividing the right side of the heart from the left. Atrial septal defects occur when the partitioning process does not occur completely, leaving an opening in the atrial septum.

在胎儿发育的第8周，心脏开始形成。开始为心管，然后在心管内出现分隔，最终形成将心脏分隔为左心和右心的间隔。如果在间隔形成的过程中发育不全，即可在房间隔上留下一个洞。

Some congenital heart defects may have a genetic link, either occurring due to a defect in a gene, a chromosome abnormality, or environmental exposure, causing heart problems to occur more often in certain families. Most atrial septal defects occur sporadically (by chance), with no clear reason for their development.

有些先天性心脏病可能有遗传因素，可能为基因缺陷、染色体异常或环境因素，在有些家庭造成心脏问题的（机会）较多。大多数房间隔缺损是偶然发生的，在发育的过程中找不到明显的原因。

Why is an atrial septal defect a concern? 房间隔缺损有什么危害？

This heart defect can cause lung problems if not repaired. When blood passes through the ASD from the left atrium to the right atrium, a larger volume of blood than normal must be handled by the right side of the heart. Extra blood then passes through the pulmonary artery into the lungs, causing higher pressure than normal in the blood vessels in the lungs.

如不进行治疗，房间隔缺损可引起肺部的问题。左心房的血液经房间隔缺损流入右心房，右心室则必须比正常心脏泵出更大量的血液。过多的血液通过肺动脉进入肺部，引起比正常人更高的肺血管压力。

A small opening in the atrial septum allows a small amount of blood to pass through from the left atrium to the right atrium. A large opening allows more blood to pass through and mix with the normal blood flow in the right heart. Extra blood causes higher pressure in the blood vessels in the lungs. The larger the volume of blood that goes to the lungs, the higher the pressure.

房间隔上的小开口可使小量血液从左心房进入右心房。大开口可使较大量血液进入右心房产生混合血。过多的血液产生较高的肺血管压力。进入肺部的血液愈多，（肺血管）的压力愈高。

The lungs are able to cope with this extra pressure for a while, depending on how high the pressure is. After a while, however, the blood vessels in the lungs become diseased by the extra pressure.

肺部应付肺血管高压的能力，取决于肺血管高压的程度。然而，肺血管高压超过一定程度，过高的压力即可产生肺血管的病变。

What are the symptoms of an atrial septal defect? 房间隔缺损的症状有哪些？

Many children have no symptoms and seem healthy. However, if the ASD is large, permitting a large amount of blood to pass through to the right side of the heart, the right atrium, right ventricle, and lungs will become overworked, and symptoms may be noted. The following are the most common symptoms of atrial septal defect. However, each child may experience symptoms differently. Symptoms may include:

很多患儿没有症状，看起来健康。然而，大的房间隔缺损可使大量血液进入右心房和右心室，肺部负担过重，则可出现症状。下面是房间隔缺损最常见的症状。不过，每个患儿可有不同的症状。症状如下：

The symptoms of an atrial septal defect may resemble other medical conditions or heart problems. Always consult your child's physician for a diagnosis. 房间隔缺损的症状的症状可能类似于其他疾病或心脏病。一定要请有关的医生做出诊断。

How is an atrial septal defect diagnosed? 如何诊断房间隔缺损？

Your child's physician may have heard a heart murmur during a physical examination, and referred your child to a pediatric cardiologist for a diagnosis. A heart murmur is simply a noise caused by the turbulence of blood flowing through the opening from the left side of the heart to the right.

医生可能在体检时听到心脏杂音，建议带孩子找儿科医生做出诊断。心脏杂音是血流从左心通过导管进入右心时产生的湍流引起的噪音。

A pediatric cardiologist specializes in the diagnosis and medical management of congenital heart defects, as well as heart problems that may develop later in childhood. The cardiologist will perform a physical examination, listening to the heart and lungs, and make other observations that help in the diagnosis. The location within the chest that the murmur is heard best, as well as the loudness and quality of the murmur (harsh, blowing, etc.) will give the cardiologist an initial idea of which heart problem your child may have. However, other tests are needed to help with the diagnosis, and may include the following:

儿科心脏病医生专门研究先天性心脏病和儿童期后一阶段发生的心脏病的诊断和内科治疗。儿科心脏病医生可进行体检，听诊心脏和肺部，进行有助于诊断的其他检查。在胸部最容易听到的杂音部位、响亮程度和性质（粗糙、吹风样，等）可以使心脏病医生得到孩子可能患有哪种心脏病的初步印象。不过，还需要其他一些检查辅助诊断，可能包括以下这些检查：

chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. With an ASD, the heart may be enlarged because the right atrium and ventricle have to handle larger amounts of blood flow than normal. Also, there may be changes that take place in the lungs due to extra blood flow that can be seen on an x-ray.
胸部X线检查－－－利用不可见电磁波穿过体内组织、骨骼和器官在胶片上形成影像的检查方法。因动脉导管未闭患者比正常人有更多血流量通过肺部，心脏可能增大。而且，由于肺部血流额外增加，X线检查可看到肺部发生改变。
electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle stress.
心电图－－－一种记录心脏电活动的检查，显示不正常的心律（心律失常或心律紊乱）和发现心肌劳损（改变）。
echocardiogram (echo) - a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves. An echo can show the pattern of blood flow through the septal opening, and determine how large the opening is, as well as how much blood is passing through it.
超声心动图－－－利用（超）声波电子传感器记录心脏和心脏瓣膜活动的图像来评价心脏结构和功能的一种检查方法。超声可显示通过房间隔缺损的血流方式，确定缺损的大小和通过血流的多少。
cardiac catheterization - a cardiac catheterization is an invasive procedure that gives very detailed information about the structures inside the heart. Under sedation, a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin, and guided to the inside of the heart. Blood pressure and oxygen measurements are taken in the four chambers of the heart, as well as the pulmonary artery and aorta. Contrast dye is also injected to more clearly visualize the structures inside the heart. If the echocardiogram has provided enough information, this procedure is often not needed to evaluate ASD.

心导管检查－－－心导管检查是一种侵入性检查方法，可获得心脏内部结构的详细资料。在镇静(药物作用)下，将柔韧的细导管插入腹

股沟的血管，导入心脏。测定4个心腔和主动脉、肺动脉的压力和血氧。亦可注入造影剂更清楚地观察心脏内部的结构。如果超声心动

图已经提供足够的资料诊断房间隔缺损，往往不必再做心导管检查。

Treatment for atrial septal defect: 房间隔缺损的治疗

Specific treatment for ASD will be determined by your child's physician based on:您孩子的医生根据以下情况决定房间隔缺损的特殊治疗方案：

Ostium secundum atrial septal defects may close spontaneously as a child grows. Once an atrial septal defect is diagnosed, your child's cardiologist will evaluate your child periodically to see whether it is closing on its own. Usually, an ASD will be repaired if it has not closed on its own by the time your child starts school - to prevent lung problems that will develop from long-time exposure to extra blood flow. The decision to close the ASD may also depend on the size of the defect. Treatment may include:

房间隔缺损随着孩子的成长可能自然闭合。一旦诊断为房间隔缺损，您孩子的心脏病医生将要（为孩子）定期检查，观察导管能否自行闭合。如果不能自行闭合，则需要手术修复，以防由于长期肺部血流过多发生肺部病变（肺动脉高压）。治疗方法包括：

medical management 内科治疗
Many children have no symptoms, and require no medications. However, some children may need to take medications to help the heart work better, since the right side is under strain from the extra blood passing through the ASD. Medication that may be prescribed include the following:
很多患儿无症状，不需要用药。但是有些患儿由于过多的血流通过房间隔缺损造成右心劳累，可能需要用药帮助心脏改善功能。可用药物包括以下这些：

digoxin - a medication that helps strengthen the heart muscle, enabling it to pump more efficiently. 地高辛---加强心肌收缩力的药物，使心脏的泵血功能更有效。
diuretics - the body's water balance can be affected when the heart is not working as well as it could. These medications help the kidneys remove excess fluid from the body. 利尿剂---如心脏功能不良，可影响全身水平衡。利尿剂可帮助肾脏排出体内过多的水分。

infection control
Children with certain heart defects are at risk for developing an infection of the inner surfaces of the heart known as bacterial endocarditis. A common procedure that puts your child at risk for this infection is a routine dental check-up and teeth cleaning. Other procedures may also increase the risk of the heart infection occurring. However, bacterial endocarditis can often be prevented by giving children with heart defects an antibiotic by mouth before the procedure. It is important that you inform all medical personnel that your child has an ASD so they may determine if the antibiotics are necessary before a procedure.
先天性心脏病患儿的心脏内表面有发生被称为心内膜炎的感染危险。一般的牙科检查和牙齿清洁这样常见的操作就可使患儿面临发生心内膜炎的危险。其他一些操作也可增加心脏感染的危险。在施行这些操纵前给予心脏病患儿抗生素，往往可以预防细菌性心内膜炎。告知所有的医务人员您的孩子患有房间隔缺损是非常重要的，他们可以决定在诊疗操作前是否需要使用抗生素。
surgical repair手术修复
Your child's ASD may be repaired surgically in the operating room, or by a cardiac catheterization procedure. The surgical repair is performed under general anesthesia. The defect may be closed with stitches or a special patch.
患儿的房间隔缺损可在手术室内手术修复，或经心导管进行介入治疗。外科手术在全身麻醉下完成。可缝合或用补片关闭房间隔缺损。
The cardiac catheterization procedure may also be an option for treatment. During the procedure, the child is sedated and a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin and guided to the inside of the heart. Once the catheter is in the heart, the cardiologist will pass a special device, called a septal occluder, into the open ASD preventing blood from flowing through it. This procedure is still very new. Consult your child's physician for more information.
经心导管进行介入治疗也是一种可选的治疗方法。患儿在镇静药物作用下，将柔韧的细导管插入腹股沟部的血管，导入心脏内。一旦导管进入心脏，心脏病医生即可将一种特制的叫做间隔堵闭器的装置送入缺损内，阻止血流经过。这种介入治疗仍然是一种新方法，可向医生进一步咨询。

Postoperative care for your child: 患儿手术后处理

In most cases, children will spend time in the intensive care unit (ICU) for several hours, or overnight, after an ASD repair. During the first several hours after surgery, your child will most likely be drowsy from the anesthesia that was used during the operation, and from medications given to relax him/her and to help with pain. As time goes by, your child will become more alert.

大多数情况下，患儿在房间隔缺损修复手术后可能需要在重症监护室内治疗几小时或一夜。由于手术中使用麻醉药，肌肉松弛药和镇痛药，患儿在手术后几小时内很可能处于昏睡状态，经过一段时间，患儿就会清醒。

While your child is in the ICU, special equipment will be used to help him/her recover, and may include the following:

在手术后重症监护室内，将使用特殊设备帮助患儿康复，包括以下设备：

ventilator - a machine that helps your child breathe while he/she is under anesthesia during the operation. A small, plastic tube is guided into the windpipe and attached to the ventilator, which breathes for your child while he/she is too sleepy to breathe effectively on his/her own. Many children have the ventilator tube removed right after surgery, but some other children will benefit from remaining on the ventilator for a few hours afterwards so they can rest.
呼吸机----当患儿在麻醉下进行手术的过程中，帮助患儿呼吸的机器。一个细塑料管插入患儿的气管内并连接到呼吸机，在患儿深睡不能自己有效呼吸的情况下帮助患儿呼吸。很多患儿在手术后可以马上拔除呼吸机插管，但也有些患儿需要继续使用呼吸机帮助呼吸数小时以利恢复。
intravenous (IV) catheters - small, plastic tubes inserted through the skin into blood vessels to provide IV fluids and important medications that help your child recover from the operation.
静脉插管----经皮肤将细塑料管插入静脉血管进行静脉输液和药物治疗，帮助患儿手术后恢复。
arterial line - a specialized IV placed in the wrist, or other area of the body where a pulse can be felt, that measures blood pressure continuously during surgery and while your child is in the ICU.
动脉测压管----在腕部或身体其他部位可触到动脉搏动处插入特制塑料细管，在手术中和监护室内持续监测患儿血压。
nasogastric (NG) tube - a small, flexible tube that keeps the stomach drained of acid and gas bubbles that may build up during surgery.
鼻胃管----经鼻孔插入的柔韧细管，在手术中吸出胃酸和气体，避免腹胀。
urinary catheter - a small, flexible tube that allows urine to drain out of the bladder and accurately measures how much urine the body makes, which helps determine how well the heart is functioning. After surgery, the heart will be a little weaker than it was before, and, therefore, the body may start to hold onto fluid, causing swelling and puffiness. Diuretics may be given to help the kidneys to remove excess fluids from the body.
导尿管----（从尿道插入的）柔韧细管，将尿液引流出膀胱并精确测量尿量，帮助判断心功能。手术后比手术前心脏功能可能变差一些，因此身体开始保留液体，引起肿大和浮肿。使用利尿剂可帮助肾脏排出过多水分。
chest tube - a drainage tube may be inserted to keep the chest free of blood that would otherwise accumulate after the incision is closed. Bleeding may occur for several hours, or even a few days after surgery.
胸腔引流管----手术中插入的胸腔引流管，可将胸部切口闭合后胸腔内积聚的血液引流出来。手术后数小时，甚至数日内可能发生出血。
heart monitor - a machine that constantly displays a picture of your child's heart rhythm, and monitors heart rate, arterial blood pressure, and other values.
心脏监测仪----可持续显示患儿的心律图形，监测心率、动脉血压和其他心功能参数的机器。

Your child may need other equipment, not mentioned here, to provide support while in the ICU, or afterwards. The hospital staff will explain all of the necessary equipment to you.

患儿在术后监护室内或以后的治疗过程中，可能还需要这里没有提到的其他设备，医务人员会向你介绍各种必要的设备。

Your child will be kept as comfortable as possible with several different medications; some which relieve pain and some which relieve anxiety. The staff may also ask for your input as to how best to soothe and comfort your child.

将使用几种药物，尽量使患儿保持舒适；有些药物用于止痛，有些用于消除焦虑。医务人员也可能要求家长参与，使患儿获得最大的安慰和舒适。

After discharged from the ICU, your child will recuperate on another hospital unit for a few days before going home. You will learn how to care for your child at home before your child is discharged. Your child may need to take medications for a while and these will be explained to you. The staff will provide instructions regarding medications, activity limitations, and follow-up appointments before your child is discharged.

离开监护室以后，患儿将回到普通病房继续（治疗）数日，康复后出院。您也要在患儿出院前学会在家里如何护理患儿。医务人员会向你解释，患儿可能需要在一定时间内服药。出院前将会指导您如何用药、限制患儿的活动量，并约定随访时间。

Care for your child at home following ASD surgical repair: 房间隔缺损手术修复后的家庭护理：

Most children feel fairly comfortable when they go home, and have a fair tolerance for activity. Your child may become tired quicker than before surgery, but usually will be allowed to play with supervision, while avoiding blows to the chest that might cause injury to the incision or breastbone. Within a few weeks, your child should be fully recovered and able to participate in normal activity.

大多数婴幼儿患者回家后都会感到相当舒适，有较好的活动能力。患儿可能比手术前较易疲劳，但一般可允许在（家长）照顾下玩耍，同时要避免胸部用力，以免损伤胸部切口和胸骨。患儿将在数周内完全康复，能够参加正常活动。

Pain medications, such as acetaminophen or ibuprofen, may be recommended to keep your child comfortable at home. Your child's physician will discuss pain control before your child is discharged from the hospital.

推荐回家后使用醋氨酚或布洛芬等止痛药保持患儿舒适。患儿的医生在出院前会（与您）讨论止痛的问题。

Long-term outlook after ASD surgical repair: 房间隔缺损手术修复后的长期效果：

The majority of children who have had an atrial septal defect surgical repair will live healthy lives. Your child's cardiologist may recommend that your child take antibiotics to prevent bacterial endocarditis for a specific time period after discharge from the hospital.

多数患儿房间隔缺损修复后可健康生活。心脏病医生可能会建议患儿出院后使用一定时间的抗生素，预防细菌性心内膜炎。

Atrial Septal Defect (ASD) 房间隔缺损

What is an atrial septal defect? 什么是房间隔缺损？