重症超声指导循环衰竭处理临床思维

发布时间：2018-03-11 08:53

本文选题：重症超声　切入点：循环衰竭　出处：《中国实用内科杂志》2017年08期 　论文类型：期刊论文

【摘要】：循环衰竭严重威胁患者生命,其病因多样,受累器官广泛,需要及时、准确地进行诊断和评估。重症医学科医师运用重症超声对循环衰竭患者进行目标导向检查,用以快速甄别休克类型和精准指导血流动力学治疗。对于循环极度衰竭患者,重症超声能迅速甄别休克类型和原因,及时明确治疗方案,识别假性无脉电活动(PEA),避免患者病情恶化,发生心脏骤停。对于一般循环衰竭的患者,重症超声则可以用流程进行休克快速评估,明确休克的类型,从而采取针对性的治疗方案,甚至可能为临床提供病因诊断的线索。在重症超声快速确定循环衰竭患者休克类型后,需要从下腔静脉、右心功能、左心收缩功能、左心舒张功能、血管张力、组织灌注等进行全方位的血流动力学六步法评估,精准指导临床治疗。
[Abstract]:Circulatory failure is a serious threat to the life of patients, its etiology is diverse, the affected organs are widespread, it needs to be diagnosed and evaluated in time and accurately. Doctors in intensive medicine use severe ultrasound to conduct goal-oriented examination on patients with circulatory failure. For rapid identification of shock types and accurate guidance for hemodynamic therapy. For patients with extreme circulatory failure, severe ultrasound can quickly identify the type and cause of shock, and define the treatment plan in a timely manner. Identify pseudo-pulseless electrical activity (PEAA) to avoid deterioration of the patient's condition and cause cardiac arrest. For patients with general circulatory failure, severe ultrasound can be used to quickly assess shock and determine the type of shock. After the severe ultrasound can quickly determine the type of shock in patients with circulatory failure, we need to use inferior vena cava, right ventricular function, left ventricular systolic function. Left ventricular diastolic function, vascular tension and tissue perfusion were evaluated by six-step hemodynamics.
【作者单位】：中日友好医院外科重症医学科;北京协和医院重症医学科;
【分类号】：R459.7

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