临床与病理杂志2017，Vol.37Issue(12)：2611-2617,7.DOI:10.3978/j.issn.2095-6959.2017.12.017
对危重患者行床旁超声心动图检查的可行性
Feasibility of using bedside transthoracic echocardiography in diagnosing cardiovascular diseases of critically ill patients
摘要
Abstract
Objective:To evaluate the accuracy rate of transthoracic echocardiography (TTE) conducted by respiratory physicians in diagnosing cardiovascular diseases of critically ill patients and analyze the associated causes of operation failure.Methods:We introduced a 2-week of comprehensively onsite TTE study under the guidance of echocardiographers on the basis of being familiar with the associated theory and normal echocardiography imaging.A total of 106 critically ill patients who hospitalized in our department were enrolled in this study.The parasternal long axis view,parasternal short axis view,apical four chamber view,subcostal four-chamber view,and the subcostal inferior vena cava view were performed by one specific physician.All of the information obtained from the five views were recorded and compared to formal echocardiography.Results:The bedside TTE was successfully performed by respiratory physicians in 94 cases.The operation time was (10.5±4.2) minutes and 42％ patients showed two more abnormal TTE imagings.The accuracy rate of diagnosis in pericardial effusion,ventrical dilation,elevated tricuspid regurgitation pressure gradient value,and the abnormal inferior vena cava were all 100％.The accuracy rate of valvular regurgitation,regional ventricular wall motion abnormities,reduction of left ventricular systolic function,and septal dyskinesia were 92.6％,95.7％,96.8％,and 96.8％ respectively.The reasons for the twelve patients with failed operation was recognized as follows:invasive mechanical ventilation (MV) in two cases,cutaneous dropsy in four cases,pneumothorax combined with invasive MV in three cases,simple pneumothorax,thoracocyllosis and positioning limitations in one case respectively.Conclusion:Respiratory physician could accomplish the TTE systematically through short-term learning and give the reliable interpretation for interested views which would be beneficial for clinical diagnosis and treatment in emergency conditions.Invasive MV,cutaneous dropsy,and pneumothorax were considered as the main reasons for operation failure in respiratory department.Furthermore,this study demonstrated a possibly new thought of TTE study for clinicians.关键词
超声心动图/危重患者/准确率Key words
echocardiography/critically ill patient/accuracy rate引用本文复制引用
王佳佳,叶加宝,雷伟,陈成,苏楠,苗玉珠,穆传勇,朱晔涵,黄建安..对危重患者行床旁超声心动图检查的可行性[J].临床与病理杂志,2017,37(12):2611-2617,7.基金项目
国家自然科学基金(81300026) （81300026）
江苏省“科教强卫工程”医学青年人才(QNRC2016747) （QNRC2016747）
苏州市临床医学中心(Szzx201502).This work was supported by the National Natural Science Foundation (81300026),the Youth Medical Talent of Jiangsu province Science and Education to Enhance Sanitary Project (QNRC2016747),and the Clinical Medicine Center of Suzhou (Szzx201502),China. （Szzx201502）
