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目的:探讨急诊床旁超声心动图检查对危重病患者床旁协助临床诊断、鉴别诊断、治疗监测的价值。方法:回顾分析1996年2月～2001年9月间行急诊床旁超声心动图检查共31例患者的资料。结果:急诊床旁超声心动图检查诊断阳性率为93.5％,大量心包积液或心包填塞占22.6％,及时心包定位穿刺;机械瓣膜急性功能障碍为12.9％,2例行急诊二次换瓣成功;感染性休克伴多器官功能障碍为9.68％,急性重症心肌炎、扩张型心肌病、大面积肺栓塞、主动脉夹层破裂、尖端扭转性室速、冠心病左心衰合并肺部感杂各2例,各占6.45％。主动脉夹层破裂、心源性休克及感染性休克伴多器官功能障碍、大面积肺栓塞抢救效果差。结论:大量心包或胸腔积液、人工瓣膜急性功能障碍、急性冠状动脉事件、急性左心衰、各种休克是临床比较常见的心脏以及相关急症,急诊床旁超声心动图检查对病因诊断、抢救治疗的监测及预后判断有重要的应用价值。
Objective: To investigate the value of emergency bedside echocardiography in clinical diagnosis, differential diagnosis and treatment monitoring of bedside assistance for critically ill patients. Methods: A retrospective analysis of the data from January 1996 to September 2001 in the emergency bedside echocardiography examination of a total of 31 patients. Results: The diagnostic positive rate of bedside echocardiography was 93.5%. A large amount of pericardial effusion or pericardial tamponade accounted for 22.6%. The pericardial puncture was performed timely. The acute valve dysfunction was 12.9% ; Septic shock with multiple organ dysfunction 9.68%, acute myocardial infarction, dilated cardiomyopathy, large pulmonary embolism, aortic dissection rupture, torsades de pointes, left heart failure with pulmonary heart disease complicated 2 For example, each account for 6.45%. Aortic dissection rupture, cardiogenic shock and septic shock with multiple organ dysfunction, large-scale pulmonary embolism rescue effect is poor. Conclusion: A large number of pericardial or pleural effusion, acute valve dysfunction, acute coronary events, acute left heart failure, all kinds of shock are more common clinical heart and related emergency, emergency bedside echocardiography for etiological diagnosis, rescue Treatment monitoring and prognosis have important application value.