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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。
Circulatory failure is a serious threat to the life of patients, its etiology and diversity, involving a wide range of organs, the need for timely and accurate diagnosis and assessment. Critical care physicians use critical ultrasound to target-oriented patients with circulatory failure to quickly screen for shock types and guide hemodynamic therapy. For patients with extreme circulatory failure, severe ultrasound can quickly identify the type and cause of shock, and promptly clear the treatment plan to identify the pseudo-pulse-free activity (PEA), to prevent the patient's condition deteriorating and cardiac arrest. For patients with general circulatory failure, severe ultrasound can be used to quickly assess the shock process, clear the type of shock to take targeted treatment programs, and may even provide clinical clues to the cause of diagnosis. After critical ultrasound to quickly determine the type of shock in patients with CPF, a comprehensive six-step hemodynamic assessment is required from the inferior vena cava, right ventricular function, left ventricular systolic function, left ventricular diastolic function, vascular tone, and tissue perfusion Precisely guide clinical treatment.