超声诊断重症患者肺栓塞临床价值

发布时间：2018-03-23 06:25

本文选题：肺栓塞　切入点：超声　出处：《中国实用内科杂志》2017年08期 　论文类型：期刊论文

【摘要】：肺栓塞是一种需要临床紧急应对的疾病,伴有血流动力学不稳定的肺栓塞患者病死率明显增加。肺栓塞的临床表现不特异,其诊断成为临床医生面临的一项难题。目前肺栓塞诊断的金标准仍然是CT肺动脉造影(CTPA),但诊断肺栓塞还需要评估患者的肺栓塞危险因素、肺栓塞的可能性以及肺栓塞的危险程度分级。超声能够发现与血流动力学不稳定相关的右心系统应变、血管内血栓、右心系统内栓子以及肺内梗死及局部胸腔积液。整合超声与传统的肺栓塞可能性评估可以进一步提高CTPA的验前概率。同时,全面的超声检查在除外肺栓塞同时还有助于寻找出其他可能的病因。因此,"心-肺-血管"联合的多器官超声检查能够在肺栓塞的逐级诊断过程中发挥不可替代的作用,理应成为一线医生诊断肺栓塞必备的武器。
[Abstract]:Pulmonary embolism is a disease requiring urgent clinical response. The mortality of patients with pulmonary embolism with hemodynamic instability is significantly increased. The diagnosis of pulmonary embolism has become a difficult problem for clinicians. At present, CT pulmonary angiography is still the gold standard for the diagnosis of pulmonary embolism, but the diagnosis of pulmonary embolism also needs to evaluate the risk factors of pulmonary embolism. The possibility of pulmonary embolism and the degree of risk of pulmonary embolism. Ultrasound can detect the right heart system strain, intravascular thrombus associated with hemodynamic instability. Emboli in the right heart system, intrapulmonary infarction and local pleural effusion. Integrated ultrasound and conventional assessment of the possibility of pulmonary embolism can further improve the pretest probability of CTPA. A comprehensive ultrasound examination, excluding pulmonary embolism, also helps to identify other possible causes. Therefore, a combination of cardiopulmonary and vascular ultrasound can play an irreplaceable role in the progressive diagnosis of pulmonary embolism. Should be the first line doctor diagnosis of pulmonary embolism necessary weapon.
【作者单位】：中国医科大学附属第一医院重症医学科;
【分类号】：R445.1;R459.7;R563.5

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