床旁超声在麻醉和危急重医学中的应用

Point of Care Ultrasonography in Anesthesia,Critical Care and Emergency Medicine

麻醉学、疼痛医学和危急重医学有许多共同特点,他们常常以稳定人体重要器官系统的功能为主要目的,因此需要快速而准确地判断出一些威胁生命的临床危急重症的原因,分秒必争地采取行之有效的治疗并持续监测病情的变化。同时,他们的病人往往转运困难和危险。在过去10年他们利用最先进的床旁超声技术为自己的临床工作服务。本文将重点介绍床旁超声技术在麻醉镇痛和危重急救医学领域中的主要用途,包括:(1)创伤病人内出血和气胸的判断;(2)各种原因导致的肺水肿;(3)呼吸道检查与紧急人工气道建立;(4)动脉瘤及动脉瘤破裂的诊断;(5)血容量和心功能的快速评估;(6)超声在心肺复苏及肺栓塞诊治中的应用;(7)胃内容物的评估;(8)围心脏手术期超声心动图监测:体外循环前心脏病变的再确诊;对手术效果的即刻评估:心血管功能的评估;(9)超声引导下的神经阻滞;(10)引导动静脉穿刺置管。

Aimed to maintaining the normal functions of patients'vital organs is the common characteristic of Anesthesia,pain medicine,and critical care medicine.The real clinical reasons related to the phenomena indeed threatening patients life should be detected quickly and accurately,as well as the effective therapies and monitoring.Bed-side ultrasonic technique has been developed during the past ten years,In this review,we highlight the new applications of ultrasonic techniques in the anesthesia and analgesia areas as well as the critical care medicine,included:(1)detecting the pneumothorax and inside haemorrhage of trauma patients,(2) pulmonary edema,(3)artificial airway establishment,(4)aneurysm and aneurysm rupture detection.(5)effectively assessment the blood volume and cardiac function.(6)pulmonary embolism detection.(7)gastric content assessment.(8)peiroperative echocardiography monitoring,and quickly re-assessment of the surgery effects.(9)nerve block under guild of ultrasonic.(10)arterial and venous puncture under the guild of ultrasonic.