超声技术在肺动脉切开取栓术抢救急性大块肺动脉栓塞中的价值

Value of ultrasound technology in rescuing patients receiving pulmonary embolectomy for acute massive pulmonary embolism

以往普遍认为CT肺动脉造影(CTPA)、核素通气灌注扫描、核磁共振血管成像等影像学检查是诊断肺动脉栓塞的主要手段。随着超声技术突飞猛进的发展,经胸超声心动图、经食道超声心动图、腹部血管超声及外周血管超声等多项超声技术联合急诊床旁应用,以其方便、快捷、直观、低成本、无创、无辐射、可重复、可动态监视血流动力学变化等优势,在抢救急性大块肺动脉栓塞中,术前得到及时诊断为抢救患者赢得时间,术中动态监视,术后疗效评估、预防复发等整个诊治过程已经起到非常重要的作用。

Imaging techniques like computed tomographic pulmonary angiography （CTPA）, radionuctide ventilation perfusion scan and magnetic resonance angiography, etc are generally considered as the main diagnosis means of pulmonary embolism. With the rapid development of ultrasound technology, emergency bedside ultrasonography of transthoracic echocardiography, transesophageal echocardiography, abdominal ultrasound and peripheral vascular ultrasound have been applied in the pulmonary embolectomy for acute massive pulmonary embolism. They have many advantages of convenience, high efficiency, direct vision, low cost, non-invasion, no radiation, repeatability, and dynamic monitoring of the hemodynamic changes, etc. Ultrasound technology has played a very important role in rescuing patients with acute massive pulmonary embolism via preoperative timely diagnosis, intraoperative dynamic monitoring, postoperative outcome assessment and recurrence prevention.