肺脏超声在新生儿肺不张疾病检查中的应用价值

目的 探讨肺脏超声在新生儿肺不张疾病检查中的应用价值.方法 选择德宏州人民医院新生儿科2018-03～2020-08收住院治疗的新生儿肺不张患儿286例,其中新生儿呼吸窘迫综合征(NRDS)121例,新生儿肺炎(PN)92例,胎粪吸入综合征(MAS)73例,均行X线胸片检查和肺脏超声检查.采用Kappa一致性检验分析两...     

床旁肺部超声在老年急性呼吸衰竭患者预后评估中的应用

目的 探讨床旁肺部超声在老年急性呼吸衰竭患者预后评估中的应用价值.方法 采用回顾性分析法,收集2018年1月至2019年1月收治的99例老年急性呼吸衰竭患者临床资料,所有患者给予床旁肺部超声检查,并根据病情给予相应呼吸支持疗法,均随访1年,根据患者预后将其分为存活组(n=76)及死亡组(n=23),仔细阅览患者病历资料...     

肺部超声在呼吸系统疾病中的应用进展

肺部超声多应用于重症医学科和急诊科对疾病的诊断，较少在呼吸科病房使用该技术。本文就肺部超声用于呼吸系统常见疾病(气胸、肺水肿、胸腔积液、支气管肺癌、肺炎、肺栓塞、间质性肺疾病、慢性阻塞性肺疾病及支气管哮喘等)的诊断进行综述，重点关注诊断方法的进展。本文为肺部超声在呼吸科病房使用提供依据。     

床旁肺部超声在脑卒中相关性肺炎诊断中的价值

目的探讨床旁肺部超声对脑卒中相关性肺炎的诊断价值。方法对脑卒中相关患者出现可疑的脑卒中相关性肺炎症状时行床旁肺部超声和胸片检查,二者检查结果不一致时行胸部CT检查。结果 52例患者纳入研究,31例被确诊为脑卒中相关性肺炎。床旁肺部超声检查敏感度为96.8%(30/31),特异度为90.5%(19/21);胸片检查的敏感度为80.7%(25/31),特异度100%(21/21)。Kappa一致性检验提示胸片和超声具有较好的一致性(k=0.657)。结论床旁肺部超声有助于脑卒中相关性肺炎的诊断。     

床旁超声在肺癌切除术后心功能评估及肺部并发症诊治中的应用研究

目的 探讨床旁超声在肺癌切除术患者心功能评估及术后肺部并发症诊治中的价值.方法 前瞻性对我院拟行肺切除术的肺癌患者进行床旁心脏超声检查,比较患者术前和术后3天的心脏超声参数(LVEF、FAC、TAPSE、ATR、PASP和E/e')的变化.对术后出现肺部并发症的患者行床旁肺超声检查,评估该检查对肺部并发症的诊断效能(以...     

超声多探头检查在新生儿颅脑疾病诊断中的应用

目的研究超声低频探头和低频探头联合高频探头检查在新生儿颅脑疾病诊断中的准确率和敏感性。 方法选取河源市妇幼保健院自2017年1月至2018年12月收治的有颅脑疾病高危因素(早产、低体质量、多胎妊娠、出生过程有缺氧窒息及产时感染)的新生儿90例作为研究对象。采用随机数字表法将所有新生儿平均分为2组,研究组（45例）给予低频探头联合高频探头进行探查,对照组（45例）仅给予低频探头进行探查。结合CT检查结果和临床治疗,比较2种检测方法的准确率和敏感性。 结果研究组检测新生儿缺氧缺血性脑病、脑室内出血和室管膜下出血诊断准确率分别为87.5%、100%、100%,高于相应对照组（15.38%、12.5%、0%）,差异有统计学意义（P<0.05）;研究组和对照组检测脑实质内出血和脑积水的诊断准确率分别为87.5%、100%以及42.85%、66.67%,差异无统计学意义（P>0.05）。研究组检测新生儿颅脑疾病的效率为82.22%,高于对照组（22.22%）,差异具有统计学意义（P<0.05）。 结论使用超声低频探头联合高频探头的方法提高了缺氧缺血性脑病、脑室内出血、室管膜下出血等新生儿颅脑疾病诊断的准确率,在诊断新生儿脑实质内出血和脑积水的准确率没有差异,且对颅脑疾病诊断的敏感性较高,因此具有较为重要的临床意义。     

急诊床旁超声的临床应用

急诊床旁超声检查是急诊医学的关键医疗技术之一,该检查与执业超声医师实施的超声检查不尽相同,急诊床旁超声主要是针对临床急症,包括严重创伤、严重血流动力学不稳定、紧急超声引导等重点部位扫查,以便及时评估急危重症患者的病情并做出快速诊疗,可极大提高急诊救治效率.该技术在急诊中的应用日益广泛,文章将对它的历史发展、应用范围以及...     

床旁超声心动图误诊新生儿罕见左心室憩室一例

1 临床资料 患儿,女,2 d.因"孕期发现室间隔缺损 4月余,出生后气促 20 h"入院.入院查体:心率126 次 /min, 呼 吸 50 次 /min, 血 压 72/34 mmHg (1 mmHg=0.133 kPa), 体 重 3.22 kg, 血 氧 饱 和 度95％,呼吸稍促,心前区可闻及Ⅳ /6 级杂音...     

床旁超声在老年危急重症患者中的应用

老年人因多器官退化和多种慢性疾病并存而造成自身体质较差,临床表现个体差异大,病情危重,进展迅速,病死率高.床旁超声具有方便、快捷、无创、无辐射,可实时动态观测、可重复操作以及可将多部位超声检查整合进行综合评估等优点.本文就床旁超声在老年危急重症患者呼吸系统、心血管系统等诊治中的应用进行综述,以期为床旁超声可视化评估在老...     

超声技术在肺部疾病诊疗中的价值

超声技术是重要的影像学诊断技术,由于肺脏包含气体,超声在肺部疾病的诊疗中存在较大局限性,呼吸科医生往往更习惯于使用X线、胸部CT及磁共振成像(MRI)等影像技术.但超声与其他影像技术相比具有独特的优势[i-2],对肺部周围型肿瘤的诊断与治疗可取得良好效果[3-4].随着近年来超声技术的迅猛发展,超声微泡载体、超声造影和腔内超声等新技术和设备日瑧完善.     

Clinical translational application of Raman spectroscopy to advance Benchside biochemical characterization to bedside diagnosis of esophageal diseases

Esophageal diseases result in significant mortality, morbidity, and health care costs worldwide. Current approaches to detect and monitor esophageal diseases have severe limitations. Advanced imaging technologies are being developed to complement current approaches to improve diagnostic, therapeutic and surveillance protocols in order to advance the field. Raman spectroscopy‐based technologies hold promise to increase the sensitivity for detection of diseased and high‐risk lesions in vitro and in vivo in real time. This technique allows for the investigation of microstructural changes and also facilitates the discovery of disease‐specific biochemical alterations with the potential to provide novel insights into the pathobiology of these conditions. Raman spectroscopy has been increasingly applied in precancerous and cancerous esophageal conditions. However, its application in benign esophageal diseases is still in the early stages. Continuing its application in cancerous and precancerous conditions and expanding its use to benign esophageal disorders could lay a foundation for integration of this technology in clinical practice and diagnostic paradigms and development of an accurate and cost‐effective tool for use in a clinical setting. Furthermore, Raman spectroscopy can also be used as an innovative technique to advance our understanding of the biochemical transformations associated with esophageal diseases and answer a myriad of fundamental questions in the field. In this review, we described the principles of Raman spectroscopy and instrumentation while providing an overview of current applications, challenges, and future directions in the context of esophageal diseases with an emphasis on its clinical translational application.     

Transthoracic ultrasound of lung and pleura in the diagnosis of pulmonary embolism: a novel non-invasive bedside approach

The diagnosis of pulmonary embolism (PE) presents a considerable challenge and requires a high index of clinical suspicion from the attending physician. In addition, diagnosing PE may require the use of one or more direct and indirect diagnostic methods. Here, transthoracic sonography (TS) provides an alternative and attractive bedside approach which is based on (1) detecting alterations in the lung parenchyma, (2) involvement of the pleura and (3) peripheral perfusion characteristics associated with thromboembolism. Using a 5 MHz or 3.5 MHz convex scanner, occasionally supplemented by a 7.5 MHz linear scanner or colour-flow Doppler mode, the intercostal areas are systematically examined by TS. Most of the PE-related lesions are localised in the lower lobes of the lung and are often associated with an area of pleuritic chest pain. The characteristic sonographic findings of TS in PE are multiple, hypoechoic, pleural-based parenchymal lesions which adopt a wedge-shape. In addition, a central echo may occasionally be detectable within the lesion. Another regular sonographic feature is the involvement of the pleura manifesting as either localised effusion, basal effusion or both. However, several differential diagnoses such as pneumonia, bronchogenic carcinoma, metastases of extra-pulmonary malignancies, and simple pleurisy need to be excluded. Since localisation of PE-associated lesions may occasionally escape sonographic detection, an inconspicuous sonographic result does not fully exclude PE. As detection of PE-associated lesions using chest ultrasonography has a high specificity and sensitivity, can be rapidly performed, is widely available, non-invasive, cost-effective, and avoids transport of critically ill patients to the investigation site, the technique may prove a valuable tool in the diagnosis of PE at bedside facilitating immediate treatment decision. Further, because the method focuses on detection of peripheral lesions it complements other diagnostic techniques employed when PE is suspected.     

超声造影技术在心脏疾病诊断中的临床运用

随着超声造影剂的广泛应用以及超声造影技术的发展,使得临床对心脏疾病的诊断研究进一步深入。本文从超声造影技术的概况、超声造影剂的分类、超声造影技术在观察心脏结构、评价心脏功能的临床运用等方面进行阐述。     

Clinical application of temporary pacemaker insertion guided by bedside ultrasound in elder and critical patients

Background Ultrasound-guided temporary pacemaker implantation has been proven safe and efficient. However, few studies have focused on elder and critical patients. Methods Twelve elder and critical patients underwent temporary cardiac pacing through the jugular vein or subclavian vein, with bedside ultrasound images to assist the placement of electrode within the right ventricle. Results Ultrasound-guided temporary cardiac pacemaker insertion was successful in all of the 12 patients. Electrodes were sent into the right ventricle correctly with the help of ultrasound imaging. In all cases, temporary pacemaker functioned well without procedure-related complications. Conclusion Temporary cardiac pacing guided by ultrasound is safe and effective in elder and critical patients, which is worth of promoting, especially in intensive care unit.     

经直肠超声对前列腺恶性肿瘤诊断的临床应用研究

目的 探讨经直肠超声诊断前列腺恶性肿瘤的临床价值。方法对218例血清前列腺特异性抗原（PSA）异常或直肠指检异常的患者行经直肠超声检查,通过与系统穿刺活检病理的比较,评价经直肠超声诊断前列腺恶性肿瘤的临床意义。结果218例患者中,经直肠超声提示前列腺癌可能者145例,穿刺活检病理证实前列腺癌76例,高级别前列腺上皮内瘤变3例,前列腺神经内分泌肿瘤1例;超声与病理的符合率为50．00％;经直肠超声诊断前列腺恶性肿瘤的灵敏度为72．5％,特异度为36．96％。结论经直肠超声是诊断前列腺恶性肿瘤的重要方法,可提高前列腺恶性肿瘤的检出率。     

心肌肌钙蛋白T快速检测对急性心肌梗死诊断的临床应用

目的探讨心肌肌钙蛋白T(cTnT)快速检测对急性心肌梗死(AMI)的早期诊断和不良后果预测价值.方法对123名高度可疑的AMI患者在发病后24小时内系列检测cTnT和肌酸激酶同工酶MB(CK-MB)活性.结果 (1)在发病后6小时、12小时和24小时内cTnT检测AMI的敏感性分别为38.8%、85.4%和94.2%,特异性为100%;(2)在发病后6小时和24小时内,CK-MB(活性)检测AMI的敏感性分别为70%和77.7%;(3)AMI患者随着cTnT水平升高,30天死亡率显著增加(P<0.01).结论 cTnT快速检测对诊断AMI具有高度的敏感性和特异性,并能预测患者的不良后果.该方法简单快速,适宜床边检测.