{"id":47303,"date":"2025-02-06T05:11:28","date_gmt":"2025-02-06T05:11:28","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=47303"},"modified":"2025-02-06T05:11:28","modified_gmt":"2025-02-06T05:11:28","slug":"%e3%80%90%e6%8c%87%e5%8d%97%e4%b8%8e%e5%85%b1%e8%af%86%e3%80%91%e5%8d%b5%e5%9c%86%e5%ad%94%e6%9c%aa%e9%97%ad%e8%a7%84%e8%8c%83%e5%8c%96%e8%af%8a%e7%96%97%e4%b8%ad%e5%9b%bd%e4%b8%93%e5%ae%b6%e5%85%b1","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=47303","title":{"rendered":"\u3010\u6307\u5357\u4e0e\u5171\u8bc6\u3011\u5375\u5706\u5b54\u672a\u95ed\u89c4\u8303\u5316\u8bca\u7597\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6"},"content":{"rendered":"

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\u4f5c\u8005:  <\/p>\n

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\u5375\u5706\u5b54\u672a\u95ed\uff08PFO\uff09\u4e0e\u7f3a\u8840\u6027\u5352\u4e2d\u3001\u5148\u5146\u504f\u5934\u75db\u7b49\u75be\u75c5\u76f8\u5173\uff0c\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u63d0\u793aPFO\u5c01\u5835\u672f\u53ef\u964d\u4f4e\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u3002\u56fd\u5185\u5916\u795e\u7ecf\u79d1\u3001\u5fc3\u810f\u79d1\u53ca\u76f8\u5173\u4e13\u4e1a\u7684\u4e13\u5bb6\u5b66\u8005\u4eec\u5bf9PFO\u76f8\u5173\u75be\u75c5\u7684\u9632\u6cbb\u65e5\u76ca\u91cd\u89c6\uff0c\u4f46\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u4ecd\u5b58\u5728\u4e00\u4e9b\u4e0d\u8db3\u3002\u4e3a\u89c4\u8303\u4e34\u5e8a\u8bca\u7597\u884c\u4e3a\uff0c\u4e2d\u534e\u533b\u5b66\u4f1a\u5fc3\u8840\u7ba1\u75c5\u5b66\u5206\u4f1a\u3001\u4e2d\u534e\u5fc3\u8840\u7ba1\u75c5\u6742\u5fd7\u7f16\u8f91\u59d4\u5458\u4f1a\u7ec4\u7ec7\u56fd\u5185\u5fc3\u8840\u7ba1\u75c5\u5b66\u4e13\u5bb6\u3001\u795e\u7ecf\u75c5\u5b66\u4e13\u5bb6\u3001\u5f71\u50cf\u8bca\u65ad\u5b66\u4e13\u5bb6\u64b0\u5199\u4e86\u8be5\u5171\u8bc6\uff0c\u660e\u786ePFO\u76f8\u5173\u7efc\u5408\u5f81\u7684\u8bca\u65ad\u6807\u51c6\u3001\u7b5b\u67e5\u548c\u8bca\u65ad\u6d41\u7a0b\u3001\u6cbb\u7597\u76ee\u6807\u548c\u7597\u6548\u8bc4\u4ef7\u4f53\u7cfb\u3002<\/p>\n

\u6b63   \u6587<\/p>\n

\u5375\u5706\u5b54\u662f\u5fc3\u810f\u80da\u80ce\u65f6\u671f\u623f\u95f4\u9694\u7684\u4e00\u4e2a\u751f\u7406\u6027\u901a\u9053\uff0c\u4f4d\u4e8e\u80da\u80ce\u671f\u539f\u53d1\u9694\u4e0e\u7ee7\u53d1\u9694\u7684\u4ea4\u754c\u5904\uff0c\u901a\u5e38\u7531\u539f\u53d1\u9694\u7684\u8584\u7247\u6837\u7ed3\u6784\u8986\u76d6\u5f62\u6210\u88c2\u9699\u6837\u5f02\u5e38\u901a\u9053\uff0c\u7c7b\u4f3c\u4e00\u529f\u80fd\u6027\u74e3\u819c\u3002\u5927\u591a\u6570\u4eba\u51fa\u751f\u540e1\u5e74\u8fbe\u5230\u89e3\u5256\u5b66\u95ed\u5408\uff0c3\u5c81\u4e4b\u540e\u4ecd\u672a\u95ed\u5408\u8005\u79f0\u4e3a\u5375\u5706\u5b54\u672a\u95ed\uff08patent foramen ovale\uff0cPFO\uff09\uff0c\u4eba\u7fa4\u60a3\u75c5\u738720%~34%\uff3b<\/sup>1, 2\uff3d<\/sup>\u3002\u81ea1564\u5e74\u610f\u5927\u5229\u5916\u79d1\u533b\u751fLeonardo Botallo\u9996\u6b21\u53d1\u73b0\u5375\u5706\u5b54\u4ee5\u6765\uff0c\u8d8a\u6765\u8d8a\u591a\u7684\u4e34\u5e8a\u7814\u7a76\u63d0\u793aPFO\u53ef\u80fd\u4e0e\u67d0\u4e9b\u75be\u75c5\u76f8\u5173\uff0c\u5982\u4e0d\u660e\u539f\u56e0\u7f3a\u8840\u6027\u5352\u4e2d\u3001\u5148\u5146\u6027\u504f\u5934\u75db\u7b49\uff3b<\/sup>2\uff3d<\/sup>\u3002\u968f\u7740\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u7684\u4e0d\u65ad\u79ef\u7d2f\uff0c\u5c24\u5176\u662f\u8fd110\u5e74\u5148\u540e\u516c\u5e03\u4e86\u4e00\u4e9b\u5927\u89c4\u6a21\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08randomized controlled trial\uff0cRCT\uff09\u7ed3\u679c\uff0c\u66f4\u591a\u7684\u4e34\u5e8a\u4e13\u5bb6\u503e\u5411\u4e8e\u5173\u95ed\u6709\u9002\u5e94\u8bc1\u7684PFO\uff0c\u4f7f\u5177\u6709\u53cd\u5e38\u6813\u585e\uff08paradoxical embolism\uff0cPE\uff09\u98ce\u9669\u7684\u60a3\u8005\u83b7\u76ca\u3002\u81ea2017\u5e749\u6708\u300a\u65b0\u82f1\u683c\u5170\u533b\u5b66\u6742\u5fd7\u300b\u540c\u671f\u53d1\u8868RESPECT\u3001CLOSE\u548cREDUCE\u7b493\u9879RCT\u540e\uff3b<\/sup>3, 4, 5\uff3d<\/sup>\uff0c\u56fd\u5185\u5916\u4f17\u591a\u4e13\u4e1a\u5b66\u672f\u56e2\u4f53\u7eb7\u7eb7\u66f4\u65b0\u5404\u81ea\u7684\u6307\u5357\/\u4e13\u5bb6\u5efa\u8bae\uff0c\u5e76\u9010\u6e10\u8fbe\u6210\u5171\u8bc6\uff1a\u5bf9\u4e8e\u8bca\u65ad\u4e3aPFO\u5e76\u7ecf\u8fc7\u8be6\u7ec6\u8bc4\u4f30\u540e\u672a\u53d1\u73b0\u5176\u4ed6\u75c5\u56e0\u7684\u7f3a\u8840\u6027\u5352\u4e2d\u60a3\u8005\uff0c\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u672f\u53ef\u964d\u4f4e\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u3002\u6b64\u540e\uff0c\u56fd\u5185\u5916\u795e\u7ecf\u79d1\u3001\u5fc3\u810f\u79d1\u53ca\u76f8\u5173\u4e13\u4e1a\u7684\u4e13\u5bb6\u5b66\u8005\u4eec\u5bf9PFO\u76f8\u5173\u75be\u75c5\u7684\u9632\u6cbb\u65e5\u76ca\u91cd\u89c6\u3002\u4f46\u662f\uff0c\u4e34\u5e8a\u79ef\u6781\u5173\u6ce8PFO\u76f8\u5173\u75be\u75c5\u9632\u6cbb\u7684\u540c\u65f6\uff0c\u4e5f\u5b58\u5728\u4e00\u4e9b\u4e0d\u8db3\uff0c\u5982PFO\u4ecb\u5165\u6cbb\u7597\u9002\u5e94\u8bc1\u628a\u63e1\u4e0d\u4e25\u3001\u64cd\u4f5c\u53ca\u672f\u540e\u968f\u8bbf\u4e0d\u89c4\u8303\u7b49\u3002\u57fa\u4e8e\u4e0a\u8ff0\u95ee\u9898\uff0c\u4e2d\u534e\u533b\u5b66\u4f1a\u5fc3\u8840\u7ba1\u75c5\u5b66\u5206\u4f1a\u4e34\u5e8a\u7814\u7a76\u5b66\u7ec4\u4e0e\u7ed3\u6784\u6027\u5fc3\u810f\u75c5\u5b66\u7ec4\u9996\u6b21\u7ec4\u7ec7\u56fd\u5185\u5fc3\u8840\u7ba1\u75c5\u5b66\u4e13\u5bb6\u3001\u795e\u7ecf\u75c5\u5b66\u4e13\u5bb6\u3001\u5f71\u50cf\u8bca\u65ad\u5b66\u4e13\u5bb6\u64b0\u5199\u672c\u5171\u8bc6\uff0c\u660e\u786ePFO\u76f8\u5173\u7efc\u5408\u5f81\u7684\u8bca\u65ad\u6807\u51c6\u3001\u7b5b\u67e5\u548c\u8bca\u65ad\u6d41\u7a0b\u3001\u6cbb\u7597\u76ee\u6807\u548c\u7597\u6548\u8bc4\u4ef7\u4f53\u7cfb\uff0c\u65e8\u5728\u8fdb\u4e00\u6b65\u89c4\u8303\u6574\u4f53\u7684\u4e34\u5e8a\u8bca\u7597\u884c\u4e3a\u3002<\/p>\n

\u4e00\u3001PFO\u76f8\u5173\u7814\u7a76\u7684\u53d1\u5c55\u7b80\u53f21877\u5e74\u5fb7\u56fd\u75c5\u7406\u5b66\u5bb6Cohnheim\u5728\u5c38\u68c0\u4e2d\u53d1\u73b0PE\uff0c\u9996\u6b21\u63d0\u51faPFO\u4e0e\u5352\u4e2d\u76f8\u5173\uff3b6\uff3d<\/sup>\u30021985\u5e74Nellessen\u7b49\uff3b7\uff3d<\/sup>\u9996\u6b21\u5e94\u7528\u8d85\u58f0\u5fc3\u52a8\u56fe\u53d1\u73b0PFO\u5904\u6709\u9a91\u8de8\u8840\u6813\uff0c1994\u5e74Brogno\u7b49\uff3b8\uff3d<\/sup>\u5728PFO\u5de6\u3001\u53f3\u5fc3\u623f\u4e24\u4fa7\u68c0\u6d4b\u5230\u8840\u51dd\u5757\uff0c\u8fd9\u4e9b\u53d1\u73b0\u4e3aPE\u63d0\u4f9b\u4e86\u76f4\u63a5\u8bc1\u636e\uff0c\u5960\u5b9a\u4e86\u9488\u5bf9PFO\u6cbb\u7597\u7684\u7406\u8bba\u57fa\u7840\u3002\u968f\u7740\u5bf9PFO\u7814\u7a76\u7684\u4e0d\u65ad\u6df1\u5165\uff0c\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u8868\u660e\u4e0d\u660e\u539f\u56e0\u5352\u4e2d\u3001\u77ed\u6682\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\u3001\u504f\u5934\u75db\u3001\u659c\u5367\u547c\u5438-\u76f4\u7acb\u6027\u4f4e\u6c27\u8840\u75c7\u7efc\u5408\u5f81\uff08platypnea-orthodeoxia syndrome\uff0cPOS\uff09\u3001\u7761\u7720\u547c\u5438\u6682\u505c\u7efc\u5408\u5f81\u3001\u51a0\u72b6\u52a8\u8109\u6b63\u5e38\u7684\u5fc3\u808c\u6897\u6b7b\u53ca\u795e\u7ecf\u51cf\u538b\u75c5\u7b49\u4e34\u5e8a\u7efc\u5408\u5f81\u4e0ePFO\u76f8\u5173\uff3b1, 2\uff3d<\/sup>\u3002\u76ee\u524d\u5df2\u6709\u8d8a\u6765\u8d8a\u591a\u7684\u5927\u578bRCT\u652f\u6301\u7ecf\u5bfc\u7ba1\u5c01\u5835PFO\u5728\u964d\u4f4e\u5352\u4e2d\u590d\u53d1\u98ce\u9669\u65b9\u9762\u4f18\u4e8e\u5355\u7eaf\u836f\u7269\u6cbb\u7597\uff3b3, 4, 5\uff0c9\uff3d<\/sup>\u3002\u6b27\u7f8e\u53ca\u6211\u56fd\u795e\u7ecf\u75c5\u5b66\u4f1a\u548c\uff08\u6216\uff09\u5fc3\u8840\u7ba1\u75c5\u5b66\u4f1a\u76f8\u7ee7\u66f4\u65b0\u4e86\u6709\u5173PFO\u6cbb\u7597\u7684\u4e13\u5bb6\u5171\u8bc6\u6216\u6307\u5357\uff3b10, 11, 12, 13, 14, 15, 16\uff3d<\/sup>\uff0c\u660e\u786e\u4e86\u7279\u5b9a\u4eba\u7fa4\u63a5\u53d7\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u6cbb\u7597\u5c06\u83b7\u76ca\u3002\u4e8c\u3001PFO\u7684\u89e3\u5256\u5b66\u7279\u5f81PFO\u4e3a\u5fc3\u810f\u623f\u95f4\u9694\u4e2d\u90e8\u88c2\u9699\uff0c\u623f\u95f4\u9694\u539f\u53d1\u9694\u548c\u7ee7\u53d1\u9694\u4e0d\u878d\u5408\u7684\u8ddd\u79bb\u4e3aPFO\u5927\u5c0f\uff0c\u91cd\u53e0\u90e8\u5206\u4e3aPFO\u957f\u5ea6\u3002\u7814\u7a76\u53d1\u73b0PFO\u5927\u5c0f\u968f\u5e74\u9f84\u589e\u5927\u800c\u589e\u52a0\uff0c\u5927\u5c0f\u8303\u56f4\u4e3a1~19 mm\uff0c\u5e73\u57474.9 mm\uff0cPFO\u957f\u5ea6\u8303\u56f4\u4e3a3~18 mm\uff0c\u5e73\u57478 mm\uff3b1, 2\uff3d<\/sup>\u3002\u6b63\u5e38\u4eba\u5de6\u5fc3\u623f\u538b\u529b\u6bd4\u53f3\u5fc3\u623f\u538b\u529b\u9ad83~5 mmHg\uff081 mmHg=0.133 kPa\uff09\uff0cPFO\u5904\u4e8e\u5173\u95ed\u72b6\u6001\u3002PFO\u539f\u53d1\u9694\u4e3a\u7ea4\u7ef4\u6837\u7ec4\u7ec7\uff0c\u8584\u4e14\u6613\u6446\u52a8\uff0c\u7ee7\u53d1\u9694\u4e3a\u808c\u6027\u7ec4\u7ec7\uff0c\u8f83\u539a\u3002\u5f53\u957f\u671f\u6216\u77ed\u6682\u53f3\u5fc3\u623f\u538b\u529b\u5347\u9ad8\u8d85\u8fc7\u5de6\u5fc3\u623f\u538b\u529b\u65f6\uff0c\u5de6\u4fa7\u8584\u5f31\u7684\u539f\u53d1\u9694\u88ab\u63a8\u5f00\uff0cPFO\u5f00\u653e\uff0c\u51fa\u73b0\u53f3\u5411\u5de6\u5206\u6d41\uff08right-to-left shunt\uff0cRLS\uff09\u3002PFO\u5408\u5e76\u623f\u95f4\u9694\u81a8\u51fa\u7624\uff08atrial septal aneurysm\uff0cASA\uff09\u4e0e\u80da\u80ce\u6b8b\u4f59\u7ed3\u6784\uff0c\u5982Eustachian\u74e3\uff08\u4e0b\u8154\u9759\u8109\u74e3\uff09\u548cChiari\u7f51\uff08\u5e0c\u963f\u91cc\u7f51\uff09\u7b49\uff0c\u5c06\u589e\u52a0\u5352\u4e2d\u98ce\u9669\uff3b1, 2\uff3d<\/sup>\u3002ASA\u662f\u623f\u95f4\u9694\u5197\u4f59\u7ec4\u7ec7\uff0c\u5728\u4e2d\u7ebf\u4f4d\u7f6e\u6446\u52a8\u5e45\u5ea6\u8f83\u5927\uff0c\u5408\u5e76ASA\u7684PFO\u60a3\u8005\u5b58\u5728\u5de6\u5fc3\u623f\u529f\u80fd\u969c\u788d\uff0c\u4fc3\u8fdb\u8840\u6813\u7684\u53d1\u751f\u53d1\u5c55\u5e76\u7ee7\u53d1\u6813\u585e\uff3b1, 2\uff3d<\/sup>\u3002\u8fc7\u957f\u7684Eustachian\u74e3\u548cChiari\u7f51\u53ef\u963b\u788d\u4e0b\u8154\u9759\u8109\u8840\u6d41\uff0c\u52a0\u91cd\u5fc3\u623f\u5185\u5206\u6d41\uff0c\u4fc3\u8fdbPE\u7684\u53d1\u5c55\uff3b1, 2\uff3d<\/sup>\u3002\u4e3a\u6307\u5bfc\u7ecf\u5bfc\u7ba1PFO\u5c01\u5835\u6cbb\u7597\uff0c\u6839\u636ePFO\u89e3\u5256\u5b66\u7279\u5f81\uff0c\u5c06PFO\u5206\u4e3a\u7b80\u5355\u578b\u548c\u590d\u6742\u578b\uff08\u88681\uff09\uff3b17\uff3d<\/sup>\uff0c\u590d\u6742\u578bPFO\u4e0e\u8111\u8840\u7ba1\u4e8b\u4ef6\u7684\u53d1\u751f\u548c\u590d\u53d1\u5bc6\u5207\u76f8\u5173\uff0c\u66f4\u5177\u4e34\u5e8a\u610f\u4e49\u3002<\/p>\n

\uff08\u70b9\u51fb\u67e5\u770b\u5927\u56fe\uff09\u4e09\u3001\u5efa\u7acbPFO\u8bca\u7597\u56e2\u961f\u7684\u91cd\u8981\u6027\u9274\u4e8ePFO\u75c7\u72b6\u7684\u591a\u6837\u6027\u548c\u4ecb\u5165\u6cbb\u7597\u7684\u4e13\u4e1a\u6027\uff0c\u4e3a\u660e\u786ePFO\u4e0e\u75c7\u72b6\u7684\u5173\u8054\u3001\u5236\u5b9a\u5e76\u5f00\u5c55\u4e2a\u6027\u5316\u6cbb\u7597\u65b9\u6848\u3001\u8bc4\u4f30\u9884\u540e\u5e76\u6307\u5bfc\u968f\u8bbf\uff0c\u4e34\u5e8a\u4e2d\u5fc3\u6709\u5fc5\u8981\u5efa\u7acbPFO\u8bca\u7597\u591a\u5b66\u79d1\u56e2\u961f\u3002\u56e2\u961f\u6210\u5458\u5e94\u5305\u62ec\u5177\u6709\u4e30\u5bcc\u7ecf\u9a8c\u7684\u795e\u7ecf\u75c5\u5b66\u3001\u5fc3\u8840\u7ba1\u75c5\u5b66\u3001\u5f71\u50cf\u8bca\u65ad\u5b66\u4e13\u5bb6\uff0c\u6839\u636e\u5177\u4f53\u60c5\u51b5\u8fd8\u53ef\u9080\u8bf7\u8840\u6db2\u79d1\u3001\u98ce\u6e7f\u79d1\u7b49\u591a\u5b66\u79d1\u4e13\u5bb6\u52a0\u5165\u3002\u795e\u7ecf\u75c5\u5b66\u4e13\u5bb6\u57fa\u4e8e\u4e0d\u660e\u539f\u56e0\u7684\u5352\u4e2d\u3001\u504f\u5934\u75db\u548c\u5176\u4ed6\u53ef\u80fd\u6d89\u53ca\u7684\u795e\u7ecf\u7cfb\u7edf\u75c7\u72b6\uff0c\u8bc4\u4f30\u5176\u4e0ePFO\u7684\u76f8\u5173\u6027\u3002\u5fc3\u8840\u7ba1\u75c5\u5b66\u4e13\u5bb6\u4e3b\u8981\u8d1f\u8d23\u8bc4\u4f30PFO\u7684\u81f4\u75c5\u6027\uff0c\u4e0e\u5176\u4ed6\u5fc3\u539f\u6027\u75c5\u56e0\u76f8\u9274\u522b\uff0c\u5b9e\u65bd\u4ecb\u5165\u5c01\u5835\u624b\u672f\uff0c\u4ee5\u53ca\u6307\u5bfc\u4fdd\u5b88\u6cbb\u7597\u3001\u4ecb\u5165\u672f\u540e\u5352\u4e2d\u9884\u9632\u7684\u836f\u7269\u9009\u62e9\u3002\u5f71\u50cf\u8bca\u65ad\u5b66\u4e13\u5bb6\u4e0d\u4ec5\u80fd\u5e2e\u52a9\u786e\u8bcaPFO\uff0c\u5bf9\u4e8e\u5176\u7ed3\u6784\u590d\u6742\u6027\u7ed9\u4e88\u8bc4\u4f30\uff0c\u540c\u65f6\u7ed3\u5408\u58f0\u5b66\u9020\u5f71\u7ed3\u679c\uff0c\u8fdb\u4e00\u6b65\u660e\u786ePFO\u81f4\u75c5\u4f5c\u7528\uff0c\u4e3a\u4ecb\u5165\u6cbb\u7597\u63d0\u4f9b\u6280\u672f\u652f\u6301\u3002\u8840\u6db2\u79d1\u3001\u98ce\u6e7f\u79d1\u4e13\u5bb6\u7b49\u5bf9\u6613\u6813\u75c7\u548c\u9ad8\u51dd\u72b6\u6001\u7b49\u7ed9\u4e88\u51c6\u786e\u6709\u6548\u7684\u8bca\u7597\u5efa\u8bae\u3002\u5c3d\u7ba1\u5bf9\u4e8ePFO\u672f\u540e\u5eb7\u590d\u5c1a\u7f3a\u4e4f\u7814\u7a76\uff0c\u4f46\u90e8\u5206\u5352\u4e2d\u540e\u60a3\u8005\u540c\u6837\u9700\u8981\u5eb7\u590d\u79d1\u8bc4\u4f30\u75c5\u60c5\u5e76\u7ed9\u4e88\u5eb7\u590d\u6307\u5bfc\uff0c\u6539\u5584\u9884\u540e\u3002\u56db\u3001PFO\u7684\u5f71\u50cf\u5b66\u8bca\u65adPFO\u7684\u5f71\u50cf\u5b66\u8bca\u65ad\u5305\u62ec\u5fc3\u810f\u89e3\u5256\u5b66\u548c\u529f\u80fd\u5b66\u8bc4\u4f30\u4e24\u65b9\u9762\uff0c\u5e38\u7528\u68c0\u67e5\u65b9\u6cd5\u5305\u62ec\u5bf9\u6bd4\u589e\u5f3a\u7ecf\u9885\u591a\u666e\u52d2\u8d85\u58f0\uff08contrast-enhanced transcranial Doppler\uff0ccTCD\uff09\u3001\u7ecf\u80f8\u8d85\u58f0\u5fc3\u52a8\u56fe\uff08transthoracic echocardiography\uff0cTTE\uff09\u3001\u7ecf\u98df\u7ba1\u8d85\u58f0\u5fc3\u52a8\u56fe\uff08transesophageal echocardiography\uff0cTEE\uff09\u548c\u53f3\u5fc3\u58f0\u5b66\u9020\u5f71\uff0c\u4e34\u5e8a\u53ef\u6839\u636e\u60a3\u8005\u5177\u4f53\u60c5\u51b5\u9009\u62e9\u3002\u5728\u7279\u6b8a\u75c5\u4f8b\u7684\u4ecb\u5165\u8bca\u7597\u4e2d\uff0c\u9009\u62e9\u6027\u5fc3\u8840\u7ba1\u9020\u5f71\u3001\u5fc3\u8154\u5185\u8d85\u58f0\u5fc3\u52a8\u56fe\uff08intracardiac echocardiography\uff0cICE\uff09\u7b49\u53ef\u63d0\u4f9b\u66f4\u6e05\u6670\u7684\u5f71\u50cf\u5b66\u8d44\u6599\u3002\uff08\u4e00\uff09cTCDcTCD\u5373\u7ecf\u9885\u591a\u666e\u52d2\u8d85\u58f0\uff08transcranial Doppler\uff0cTCD\uff09\u00ad\u58f0\u5b66\u9020\u5f71\uff0c\u53c8\u540dTCD\u53d1\u6ce1\u8bd5\u9a8c\uff0c\u4e3b\u8981\u7528\u4e8e\u68c0\u6d4bRLS\u3002\u5176\u539f\u7406\u662f\u9759\u606f\u72b6\u6001\u53caValsalva\u52a8\u4f5c\u4e0b\u6ce8\u5c04\u6fc0\u6d3b\u751f\u7406\u76d0\u6c34\uff0c\u4f7f\u7528TCD\u8bbe\u5907\u76d1\u6d4b\u8111\u8840\u6d41\u65f6\uff0c\u82e5\u5b58\u5728RLS\uff0c\u7ecf\u989e\u7a97\u76d1\u6d4b\u53cc\u4fa7\u5927\u8111\u4e2d\u52a8\u8109\u6216\u5355\u4fa7\u5927\u8111\u4e2d\u52a8\u8109\u53ef\u89c2\u5bdf\u5230\u5fae\u6c14\u6ce1\uff0c\u4e34\u5e8a\u5e38\u7528\u4e8e\u7b5b\u67e5PFO\u53ca\u5224\u65adRLS\u7b49\u7ea7\uff3b<\/sup>18, 19, 20\uff3d<\/sup>\u30021.\u68c0\u67e5\u6d41\u7a0b\u53ca\u64cd\u4f5c\u65b9\u6cd5\uff1a\u60a3\u8005\u53d6\u4ef0\u5367\u4f4d\uff0c\u64cd\u4f5c\u8005\u4e8e\u5927\u8111\u4e2d\u52a8\u8109\u5904\u56fa\u5b9a\u597d\u68c0\u67e5\u63a2\u5934\u3002\u91c7\u752818~20 G\u5957\u7ba1\u9488\u7559\u7f6e\u901a\u8def\uff0c\u63a5\u4e0a\u4e09\u901a\u9600\uff0c\u4e09\u901a\u5206\u522b\u63a52\u652f10 ml\u6ce8\u5c04\u5668\uff0c\u5176\u4e2d1\u652f\u5438\u53d60.9%\u6c2f\u5316\u94a0\u6eb6\u6db29 ml\u53ca1\u6ef4\u60a3\u8005\u8840\u6db2\uff0c\u53e61\u652f\u5438\u53d61 ml\u7a7a\u6c14\uff08\u5efa\u8bae\u4ece0.9%\u6c2f\u5316\u94a0\u6eb6\u6db2\u74f6\u5185\u76f4\u63a5\u62bd\u53d6\u6d01\u51c0\u7684\u7a7a\u6c14\uff09\uff0c\u6765\u56de\u63a8\u6ce820\u6b21\u5747\u5300\u6df7\u5408\uff0c\u5236\u6210\u6fc0\u6d3b\u751f\u7406\u76d0\u6c34\u3002\u5b89\u9759\u72b6\u6001\u4e0b\uff0c\u6253\u5f00\u5fae\u6ce1\u76d1\u6d4b\u8f6f\u4ef6\uff0c\u4e00\u540d\u64cd\u4f5c\u8005\u5feb\u901f\u63a8\u6ce8\u6fc0\u6d3b\u751f\u7406\u76d0\u6c34\uff0c\u540c\u65f6\u53e6\u4e00\u540d\u64cd\u4f5c\u8005\u76d1\u6d4b\u5e76\u8bb0\u5f5525 s\u5185\u5fae\u6ce1\u68c0\u51fa\u60c5\u51b5\u3002\u95f4\u96942 min\uff0c\u5631\u60a3\u8005\u884cValsalva\u52a8\u4f5c\u5e76\u518d\u6b21\u91cd\u590d\u4e0a\u8ff0\u64cd\u4f5c\uff0ccCTD\u76d1\u6d4b\u9891\u8c31\u89c1\u56fe1\u3002<\/p>\n

\uff08\u70b9\u51fb\u67e5\u770b\u5927\u56fe\uff09<\/p>\n

\u5bf9\u4e8e\u65e0\u6cd5\u6267\u884c\u6807\u51c6Valsalva\u52a8\u4f5c\u4e14\u9ad8\u5ea6\u6000\u7591\u5b58\u5728RLS\u7684\u60a3\u8005\u53ef\u9009\u62e9\u538b\u529b\u8868\uff3b<\/sup>21\uff3d<\/sup>\u6216Valsalva\u52a8\u4f5c\u8f85\u52a9\u5668\/\u547c\u5438\u8bad\u7ec3\u5668\uff3b<\/sup>22\uff3d<\/sup>\uff08\u56fe2\uff09\u7b49\u8f85\u52a9\u5b8c\u6210\u68c0\u67e5\uff0c\u4f7f\u538b\u529b\u8ba1\u663e\u793a\u538b\u529b\u8fbe\u523040 mmHg\uff0c\u6301\u7eed10 s\u3002\u538b\u529b\u8868\u6216\u547c\u5438\u8bad\u7ec3\u5668\u53ef\u76f4\u89c2\u663e\u793a\u52a8\u4f5c\u662f\u5426\u8fbe\u6807\u3001\u63d0\u4f9b\u53ca\u65f6\u53cd\u9988\uff0c\u4f7fValsalva\u52a8\u4f5c\u66f4\u5bb9\u6613\u638c\u63e1\u548c\u6267\u884c\u3002<\/p>\n<\/p>\n

\uff08\u70b9\u51fb\u67e5\u770b\u5927\u56fe\uff09<\/p>\n

2.RLS\u8bc4\u4f30\u65b9\u6cd5\uff1a\u9759\u606f\u72b6\u6001\u4e0b\u5373\u5b58\u5728RLS\u4e3a\u56fa\u6709\u578b\u3002\u9759\u606f\u72b6\u6001\u4e0b\u65e0\u5206\u6d41\uff0cValsalva\u52a8\u4f5c\u4e0b\u6fc0\u53d1\u51faRLS\u4e3a\u6f5c\u5728\u578b\u3002\u6309\u5fae\u6ce1\u6570\u91cf\u5c06RLS\u5206\u4e3a4\u7ea7\uff0c\u5177\u4f53\u5982\u4e0b\u30020\u7ea7\uff1a\u65e0\u5fae\u6ce1\u4fe1\u53f7\uff0c\u65e0RLS\uff1b\u2160\u7ea7\uff1a1~10\u4e2a\u5fae\u6ce1\u4fe1\u53f7\uff08\u53cc\u4fa71~20\u4e2a\uff09\uff0c\u4e3a\u5c11\u91cfRLS\uff1b\u2161\u7ea7\uff1a>10\u4e2a\u5fae\u6ce1\u4fe1\u53f7\uff08\u53cc\u4fa7>20\u4e2a\uff09\u3001\u975e\u96e8\u5e18\u72b6\uff0c\u4e3a\u4e2d\u91cfRLS\uff1b\u2162\u7ea7\uff1a\u6813\u5b50\u4fe1\u53f7\u5448\u96e8\u5e18\u72b6\u6216\u6dcb\u6d74\u578b\uff0c\u4e3a\u5927\u91cfRLS\u3002\uff08\u4e8c\uff09\u8d85\u58f0\u5fc3\u52a8\u56fe\u8d85\u58f0\u5fc3\u52a8\u56fe\u8bca\u65adPFO\u7684\u65b9\u6cd5\u4e3b\u8981\u5305\u62ecTTE\u3001TEE\u548c\u53f3\u5fc3\u58f0\u5b66\u9020\u5f71\u7b49\uff3b<\/sup>23, 24, 25\uff3d<\/sup>\u30021.TTE\uff1aTTE\u5728\u5927\u52a8\u8109\u77ed\u8f74\u3001\u5fc3\u5c16\u56db\u8154\u5fc3\u53ca\u5251\u4e0b\u4e24\u623f3\u4e2a\u5207\u9762\u89c2\u5bdf\u623f\u95f4\u9694\uff0c\u68c0\u6d4b\u662f\u5426\u5b58\u5728\u539f\u53d1\u9694\u4e0e\u7ee7\u53d1\u9694\u5206\u79bb\u53ca\u5206\u6d41\u3002\u4f46\u6210\u5e74\u4eba\u58f0\u7a97\u8d28\u91cf\u6709\u65f6\u6b20\u4f73\uff0c\u4e14PFO\u4f4d\u4e8e\u56fe\u50cf\u8fdc\u573a\uff0c\u5bf9PFO\u8bca\u65ad\u51c6\u786e\u7387\u8f83\u4f4e\uff0c\u5bb9\u6613\u8bef\u8bca\u6216\u6f0f\u8bca\uff0c\u56e0\u6b64TTE\u4e3b\u8981\u5e94\u7528\u4e8e\u5fc3\u810f\u7ed3\u6784\u65b9\u9762\u7684\u6392\u9664\u6027\u7b5b\u67e5\uff0c\u5224\u65ad\u662f\u5426\u5408\u5e76\u623f\u95f4\u9694\u7f3a\u635f\uff08atrial septal defect\uff0cASD\uff09\u6216\u5176\u4ed6\u7ed3\u6784\u6027\u5f02\u5e38\u7b49\u30022.TEE\uff1aTEE\u63a2\u5934\u4f4d\u4e8e\u98df\u7ba1\u5185\uff08\u5fc3\u810f\u540e\u65b9\uff09\uff0c\u907f\u514d\u4e86\u80a5\u80d6\u3001\u80ba\u6c14\u80bf\u3001\u80f8\u5ed3\u7578\u5f62\u7b49\u5f71\u54cd\uff0c\u80fd\u6e05\u6670\u89c2\u5bdf\u623f\u95f4\u9694\u89e3\u5256\u7ed3\u6784\uff0c\u662f\u8bca\u65adPFO\u7684\u201c\u91d1\u6807\u51c6\u201d\u3002\u4e3b\u8981\u89c2\u5bdf\uff1a\uff081\uff09\u98df\u7ba1\u4e2d\u6bb5\u4e3b\u52a8\u8109\u77ed\u8f74\u5207\u9762\uff0850\u00b0~70\u00b0\uff09\uff0c\u53ef\u6d4b\u91cfPFO\u53f3\u5fc3\u623f\u5206\u6d41\u53e3\u81f3\u4e3b\u52a8\u8109\u6839\u90e8\u8ddd\u79bb\uff1b\uff082\uff09\u98df\u7ba1\u4e2d\u6bb5\u53cc\u8154\u9759\u8109\u5207\u9762\uff0890\u00b0~120\u00b0\uff09\uff0c\u53ef\u6d4b\u91cf\u4ecePFO\u53f3\u5fc3\u623f\u9762\u5206\u6d41\u53e3\u81f3\u4e0a\u8154\u9759\u8109\u53e3\u7684\u8ddd\u79bb\uff1b\uff083\uff09\u4e09\u7ef4TEE\u53ef\u66f4\u4e3a\u6e05\u6670\u5730\u63a2\u67e5\u623f\u95f4\u9694\u7684\u89e3\u5256\u7ed3\u6784\uff0c\u76f4\u89c2\u5730\u663e\u793aPFO\u53ca\u5176\u5468\u56f4\u7ed3\u6784\u3002\u901a\u5e38\u6839\u636eTEE\u6d4b\u5f97\u7684PFO\u7684\u5927\u5c0f\uff0c\u5c06PFO\u5206\u4e3a\u5927PFO\uff08\u22654.0 mm\uff09\u3001\u4e2dPFO\uff082.0~3.9 mm\uff09\u548c\u5c0fPFO\uff08<2.0 mm\uff093\u79cd\u7c7b\u578b\u3002\u6709\u6548Valsalva\u52a8\u4f5c\u540e\u6d4b\u91cf\u7684\u6700\u5927PFO\u5f00\u653e\u76f4\u5f84\u63a5\u8fd1\u5176\u771f\u5b9e\u5927\u5c0f\u30023.\u53f3\u5fc3\u58f0\u5b66\u9020\u5f71\uff1a\u53f3\u5fc3\u58f0\u5b66\u9020\u5f71\u5305\u62ec\u7ecf\u80f8\u8d85\u58f0\u5fc3\u52a8\u56fe\u53f3\u5fc3\u58f0\u5b66\u9020\u5f71\uff08contrast transthoracic echocardiography\uff0ccTTE\uff09\u548c\u7ecf\u98df\u7ba1\u8d85\u58f0\u5fc3\u52a8\u56fe\u53f3\u5fc3\u58f0\u5b66\u9020\u5f71\uff08contrast transesophageal echocardiography\uff0ccTEE\uff09\u3002\u5c06\u632f\u8361\u751f\u7406\u76d0\u6c34\uff081 ml\u7a7a\u6c14 1 ml\u56de\u6536\u8840\u6db2 8 ml\u751f\u7406\u76d0\u6c34\uff09\u4ea7\u751f\u7684\u5fae\u6c14\u6ce1\u4f5c\u4e3a\u9020\u5f71\u5242\uff0c\u56e0\u632f\u8361\u5fae\u6c14\u6ce1\u4e0d\u80fd\u901a\u8fc7\u80ba\u6bdb\u7ec6\u8840\u7ba1\u7f51\uff0c\u53ea\u80fd\u663e\u793a\u53f3\u5fc3\u8154\uff0c\u53ef\u6e05\u6670\u663e\u793aPFO\u5904\u5206\u6d41\u7684\u5927\u5c0f\u53ca\u65b9\u5411\uff0c\u6545\u53ef\u501f\u6b64\u5224\u65ad\u662f\u5426\u5b58\u5728\u5fc3\u5185\u5206\u6d41\u53ca\u80ba\u5185\u5206\u6d41\u3002cTTE\u5728\u5fc3\u5c16\u56db\u8154\u5fc3\u5207\u9762\u5148\u540e\u89c2\u5bdf\u9759\u606f\u53caValsalva\u52a8\u4f5c2\u79cd\u72b6\u6001\u7684\u9020\u5f71\u7ed3\u679c\u3002Valsalva\u52a8\u4f5c\u65f6\uff0c\u5408\u683c\u7684\u9020\u5f71\u56fe\u50cf\u5fc5\u987b\u540c\u65f6\u6ee1\u8db3\u4ee5\u4e0b2\u4e2a\u6761\u4ef6\uff1a\uff081\uff09\u6fc0\u53d1\u52a8\u4f5c\u8bf1\u53d1\u53f3\u5fc3\u623f\u538b\u529b\u9ad8\u4e8e\u5de6\u5fc3\u623f\u538b\u529b\uff0c\u4f7f\u623f\u95f4\u9694\u5411\u5de6\u5fc3\u623f\u81a8\u51fa\uff1b\uff082\uff09\u53f3\u5fc3\u623f\u5185\u5b8c\u5168\u5145\u76c8\u5fae\u6c14\u6ce1\uff0c\u5c24\u5176\u662f\u90bb\u8fd1\u623f\u95f4\u9694\u533a\u57df\uff08\u5375\u5706\u7a9d\u65c1\uff09\u3002\u6839\u636ecTTE\u89c2\u5bdf\u5230\u7684\u5fae\u6c14\u6ce1\u7684\u6765\u6e90\u4f4d\u7f6e\u3001\u51fa\u73b0\u7684\u65f6\u95f4\u8282\u70b9\uff083~6\u4e2a\u5fc3\u52a8\u5468\u671f\uff09\u3001\u65f6\u95f4\u957f\u5ea6\uff08\u4e00\u8fc7\u6027\/\u6301\u7eed\u6027\uff09\u7684\u663e\u5f71\u7279\u5f81\u5224\u65ad\u662f\u5426\u5b58\u5728\u5fc3\u5185\u5206\u6d41\u548c\uff08\u6216\uff09\u80ba\u5185\u5206\u6d41\uff0c\u8bca\u65ad\u6d41\u7a0b\u89c1\u56fe3\u3002<\/p>\n

\uff08\u70b9\u51fb\u67e5\u770b\u5927\u56fe\uff09\u76ee\u524dcTTE\u5e38\u7528\u7684\u8bc4\u4f30\u6807\u51c6\u5982\u4e0b\uff0c\u6309\u7167\u9759\u6b62\u7684\u5355\u5e27\u56fe\u50cf\u4e0a\u5de6\u5fc3\u8154\u5185\u51fa\u73b0\u7684\u5fae\u6ce1\u6570\u91cf\u5c06RLS\u5206\u4e3a4\u7ea7\uff1a0\u7ea7\uff0c\u5de6\u5fc3\u8154\u5185\u65e0\u5fae\u6ce1\uff0c\u65e0RLS\uff1b\u2160\u7ea7\uff0c\u5de6\u5fc3\u8154\u5185\u53ef\u89c1<10\u4e2a\u5fae\u6ce1\/\u5e27\uff0c\u4e3a\u5c11\u91cfRLS\uff1b\u2161\u7ea7\uff1a\u5de6\u5fc3\u8154\u5185\u53ef\u89c110~30\u4e2a\u5fae\u6ce1\/\u5e27\uff0c\u4e3a\u4e2d\u91cfRLS\uff1b\u2162\u7ea7\uff1a\u5de6\u5fc3\u8154\u5185\u53ef\u89c1>30\u4e2a\u5fae\u6ce1\/\u5e27\uff0c\u6216\u5de6\u5fc3\u8154\u51e0\u4e4e\u5145\u6ee1\u5fae\u6ce1\/\u5fc3\u8154\u6d51\u6d4a\uff0c\u4e3a\u5927\u91cfRLS\uff08\u56fe4\uff09\u3002<\/p>\n

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pulmonary angiography\uff0cCTPA\uff09\u65e8\u5728\u660e\u786e\u6709\u65e0\u5176\u4ed6\u4f34\u53d1\u75be\u60a3\u3002\u5bf9\u4e8e\u672f\u524dcTTE\u6216cTEE\u68c0\u67e5\u63d0\u793a\u6709\u80ba\u9759\u8109\u6765\u6e90\u7684\u5fae\u6ce1\u8fdb\u5165\u5de6\u5fc3\u623f\u7684\u60a3\u8005\uff0c\u53ef\u4ee5\u901a\u8fc7CTPA\u6392\u9664\u6216\u786e\u8bca\u9700\u8981\u4ecb\u5165\u5e72\u9884\u7684\u80ba\u52a8\u9759\u8109\u7618\uff08pulmonary arteriovenous fistula\uff0cPAF\uff09\uff0c\u5373\u76f4\u5f841 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min\u540e\u51fa\u73b0\u75c7\u72b6\uff3b<\/sup>69\uff3d<\/sup>\u3002\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0c\u6709\u4e9b\u60a3\u8005\u4e34\u5e8a\u8868\u73b0\u53ef\u80fd\u975e\u5e38\u8f7b\u5fae\u4e14\u80fd\u81ea\u6108\uff0c\u4ece\u800c\u6613\u5bfc\u81f4\u4e34\u5e8a\u6f0f\u8bca\uff0c\u589e\u52a0\u80f8\u8154\u5185\u538b\u529b\u7684\u8fd0\u52a8\u6216\u7c7b\u4f3cValsalva\u52a8\u4f5c\u53ef\u80fd\u4f1a\u8bf1\u53d1\u75c7\u72b6\uff0c\u6709\u52a9\u4e8e\u660e\u786e\u8bca\u65ad\uff3b<\/sup>69\uff3d<\/sup>\u3002\u51cf\u538b\u75c5\u7684\u6700\u4f73\u6cbb\u7597\u65b9\u6cd5\u662f\u5c3d\u5feb\u8fdb\u884c100%\u7684\u6c27\u6c14\u6cbb\u7597\uff0c\u7ed3\u5408\u9759\u8109\u8f93\u6db2\u548c\u9ad8\u538b\u6c27\u6cbb\u7597\uff3b<\/sup>70\uff3d<\/sup>\u3002\u4e34\u5e8a\u7814\u7a76\u53ca\u957f\u671f\u968f\u8bbf\u7ed3\u679c\u63d0\u793a\uff0c\u5173\u95edPFO\u53ef\u6709\u6548\u964d\u4f4ePFO\u76f8\u5173\u51cf\u538b\u75c5\u7684\u98ce\u9669\uff0c\u5c24\u5176\u662f\u590d\u6742\u578bPFO\u3001\u6709\u81ea\u53d1\u6027\u51cf\u538b\u75c5\u75c5\u53f2\u6216\u6f5c\u6c34\u7231\u597d\u8005\uff3b<\/sup>71, 72, 73, 74\uff3d<\/sup>\u3002PFO\u672f\u540e\u51cf\u538b\u75c5\u590d\u53d1\u4e00\u822c\u4e0e\u6b8b\u4f59\u5206\u6d41\u6709\u5173\uff3b<\/sup>75\uff3d<\/sup>\uff0c\u4e5f\u53ef\u80fd\u662f\u5408\u5e76\u5176\u4ed6\u673a\u5236\uff0c\u5982\u7ec4\u7ec7\u6c34\u5e73\u7684\u6c2e\u6c14\u6ce1\u8fc7\u5ea6\u81a8\u80c0\u5f15\u8d77\u7684\u51cf\u538b\u75c5\u6216\u901a\u8fc7\u80ba\u5faa\u73af\u7684\u6c14\u4f53\u6813\u585e\u7b49\uff3b<\/sup>61\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u590d\u6742\u578bPFO\u662f\u81ea\u53d1\u6027\u51cf\u538b\u75c5\u7684\u9ad8\u5371\u56e0\u7d20\uff0c\u8d85\u58f0\u7b5b\u67e5\u548c\u98ce\u9669\u5206\u5c42\u7b56\u7565\u53ef\u964d\u4f4e\u51cf\u538b\u75c5\u53d1\u751f\u7387\uff0cPFO\u5c01\u5835\u53ef\u964d\u4f4e\u6f5c\u6c34\u5458\u7b49\u76f8\u5173\u804c\u4e1a\u4eba\u5458\u7f79\u60a3\u51cf\u538b\u75c5\u548cPFO-AS\u7684\u98ce\u9669\uff0c\u4f46\u9700\u6743\u8861\u5229\u5f0a\uff0c\u5982\u679c\u662f\u975e\u804c\u4e1a\u4eba\u5458\uff0c\u4ee5\u4e34\u5e8a\u968f\u8bbf\u4e3a\u4e3b\uff3b<\/sup>66\uff3d<\/sup>\u3002\uff08\u4e94\uff09PFO\u4e0e\u5176\u4ed6\u4e34\u5e8a\u7efc\u5408\u5f81PFO\u76f8\u5173\u75c7\u72b6\u4e3b\u8981\u7531\u5176\u4ecb\u5bfc\u7684PE\u5f15\u8d77\u3002\u9664\u8111\u6897\u6b7b\u5916\uff0c\u5fc3\u808c\u6897\u6b7b\u6700\u4e3a\u5e38\u89c1\uff0c\u60a3\u8005\u53ef\u8868\u73b0\u4e3a\u5178\u578bST\u6bb5\u62ac\u9ad8\u578b\u5fc3\u808c\u6897\u6b7b\u3001\u975e\u6591\u5757\u6813\u585e\u3001\u6c14\u6813\u6027\u5fc3\u808c\u6897\u6b7b\uff3b<\/sup>76, 77, 78\uff3d<\/sup>\u3002\u5176\u4ed6\u810f\u5668\u6897\u6b7b\u4e5f\u6709\u62a5\u9053\uff0c\u5305\u62ecPFO\u76f8\u5173\u80be\u52a8\u8109\u6813\u585e\uff3b<\/sup>79\uff3d<\/sup>\u3001\u89c6\u7f51\u819c\u52a8\u8109\u6813\u585e\uff3b<\/sup>80\uff3d<\/sup>\u3002\u8fdc\u7aef\u80a2\u4f53\u52a8\u8109\u6813\u585e\u4e5f\u53ef\u7531PFO\u76f8\u5173\u7684PE\u5f15\u8d77\uff0c\u5305\u62ec\u5934\u81c2\u52a8\u8109\u3001\u624b\u81c2\u548c\u624b\u6307\u52a8\u8109\u6813\u585e\uff3b<\/sup>81, 82, 83\uff3d<\/sup>\u3002\u5c3d\u7ba1\u7f3a\u4e4f\u76f4\u63a5\u8bc1\u636e\uff0c\u4e0d\u660e\u539f\u56e0\u6655\u53a5\u3001\u766b\u75eb\u3001\u795e\u7ecf\u6027\u542c\u529b\u4e27\u5931\u3001\u4e00\u8fc7\u6027\u9ed1\u77c7\u548c\u7cbe\u795e\u5f02\u5e38\u4e5f\u6709\u53ef\u80fd\u4e0ePFO\u4ecb\u5bfc\u7684PE\u76f8\u5173\uff3b<\/sup>84, 85, 86\uff3d<\/sup>\uff0c\u5fae\u91cf\u8840\u6813\u7ecf\u7531PFO\u8fdb\u5165\u52a8\u8109\uff0c\u9020\u6210\u77ed\u6682\u6027\u8111\u7f3a\u8840\u53d1\u4f5c\u6240\u81f4\u3002\u4f5c\u4e3a\u5fc3\u5185\u5f02\u5e38\u5206\u6d41\u7684\u901a\u9053\uff0cPFO\u4ea6\u53ef\u4ecb\u5bfc\u4e09\u5c16\u74e3\u8d58\u751f\u7269\u8fdb\u5165\u5de6\u5fc3\u7cfb\u7edf\u9020\u6210\u611f\u67d3\u6027\u5fc3\u5185\u819c\u708e\uff3b<\/sup>87\uff3d<\/sup>\u3002\u5c3d\u7ba1\u76ee\u524d\u8ba4\u4e3aPFO\u4e3b\u8981\u4f5c\u4e3a\u5fc3\u5185\u901a\u9053\u4ecb\u5bfcPE\u7684\u53d1\u751f\uff0c\u4f46\u5176\u7279\u6b8a\u7ed3\u6784\u4e5f\u53ef\u80fd\u6210\u4e3a\u8840\u6813\u539f\u53d1\u5730\uff0c\u9020\u6210\u4e25\u91cd\u80ba\u52a8\u8109\u6813\u585e\uff3b<\/sup>88\uff3d<\/sup>\u3002\u9274\u4e8ePFO\u76f8\u5173\u75c7\u72b6\u8868\u73b0\u591a\u6837\uff0c\u7d2f\u53ca\u5668\u5b98\u591a\uff0c\u5728\u4e34\u5e8a\u5de5\u4f5c\u4e2d\u9700\u8c28\u614e\u8bc4\u4f30\u9274\u522b\uff0c\u786e\u6709\u4f53\u5faa\u73af\u6813\u585e\u4e14\u65e2\u5f80\u65e0PFO-AS\u7684\u60a3\u8005\u4e2d\uff0c\u5728\u6392\u9664\u5176\u4ed6\u6813\u585e\u75c5\u56e0\u540e\uff0c\u53ef\u8003\u8651PFO\u5c01\u5835\u3002\u7ecf\u76ae\u5bfc\u7ba1PFO\u5c01\u5835\u672f\u80fd\u6709\u6548\u964d\u4f4ePE\u7684\u98ce\u9669\uff0c\u4f46\u5177\u6709\u4ee5\u4e0b\u60c5\u51b5\u7684\u60a3\u8005\uff0c\u5373\u4f7f\u5b58\u5728PFO\u76f8\u5173\u75be\u75c5\uff0c\u76ee\u524d\u4e5f\u6682\u4e0d\u63a8\u8350\u884cPFO\u5c01\u5835\u672f\uff1a\uff081\uff09\u80ba\u52a8\u8109\u9ad8\u538b\u6216PFO\u4f5c\u4e3a\u7279\u6b8a\u901a\u9053\uff1b\uff082\uff09\u8fd1\u671f\u6709\u4e25\u91cd\u51fa\u8840\u75c5\u53f2\uff1b\uff083\uff09\u5168\u8eab\u6216\u5c40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