床旁超声心动图在急危重心血管疾病中的临床应用

Clinical application of bedside echocardiography in acute and severe cardiovascular diseases

目的探讨床旁超声心动图在急危重症心血管疾病中的临床应用价值。方法回顾性分析2015年1月至12月中国医科大学附属第一医院超声科急危重心血管病患者行床旁超声心动图检查的患者,共2 532例。采用Philips CX-50超声仪,探头频率1.0~5.0 MHz,将机器推至床旁,在临床医师共同参与下,进行超声心动图检查。结果床旁超声心动图检查的阳性结果 2 447例,阳性率为96.6%,包括心肌梗死1 115例(45.6%,心梗并发症339例),心内/外科术后356例(14.5%),心包积液360例(14.7%),肺高压322例(13.2%,其中直接征象肺栓塞7例),心肌病66例(2.7%),主动脉夹层/瘤55例(2.2%),瓣膜病50例(2.0%),先心病49例(2.0%),心房黏液瘤8例(0.3%)。上述阳性结果中左室射血分数减低(LVEF<50%)736例(30.1%)。结论床旁超声心动图为急危重症心血管疾病的诊断及治疗提供便捷、及时、安全、可靠的信息,也是监测病情变化、判断疗效和预后的重要工具,具有重要的临床应用价值。

Objective To investigate the application value of bedside echocardiography in acute and severe cardiovascular diseases. Methods 2 532 cases with acute and severe cardiovascular disorders underwent beside echocardiograpby were retrospectively analyzed from January 2015 to December 2015 in the First Affiliated Hospital of China Medical University.Philips CX-50 ultrasound equipment with 1.0 ~ 5.0 MHz probe frequency, was pushed to bed with the participation of clinician. Results The positive cases and positive rate of beside echocardiography were 2 447 and 96.6% respectively, including 1 115 cases with myocardial infarction （45.6% ,339 cases with complications） ,356 cases after cardiac surgery （ 14.5% ） ,360 cases with pericardial effusion （14.7%） ,322 cases with pulmonary hypertension （ 13.2% ,7 cases with direct signs of pulmonary embolism）, 66 cases with cardiomyopathy （2.7%）, 55 cases with aortic dissection or aneurysm （2.2%）, 50 cases with valvular heart disease （2.0%）, 49 cases with congenital heart disease （2.0%） and 8 cases with atrial myxoma （0.3%）.In the positive findings, there were 736 cases （30.1%） with lower left ventricular ejection fraction （LVEF 〈 50%）. Conclusions Bedside echocardiography, can provide convenient, prompt, safe, reliable information for diagnosis and treatment of critical cardiovascular diseases and is also an important tool for monitoring condition change and judging the curative effect and prognosis, has the important value of clinical application.