DeCara Jeanne M, Lang Roberto M, Spencer Kirk T
University of Chicago Medical Center, Chicago, Illinois 60637, USA.
Echocardiography. 2003 Jul;20(5):477-85. doi: 10.1046/j.1540-8175.2003.03071.x.
Physical examination skills have been declining over the past several decades while technology has made diagnostic testing increasingly sophisticated. For patients with cardiovascular disease, the best approach to bedside diagnosis would be one that combines both physical examination and ready access to technology at the time of the patient encounter. Most cardiac testing is not performed at the bedside due to equipment size and time limitations for these tests. Small hand-carried echocardiographic devices are now available for rapid bedside examination. These devices compare well to full-featured systems when used in cardiology outpatient settings and in hospitalized patients who are not critically ill. Compared with physical examination by board certified cardiologists, these devices decrease diagnostic error. Early use of hand-carried echocardiographic devices after physical examination has been demonstrated to impact patient triage and treatment as well as uncover otherwise undetected cardiac disease. The degree of training required for responsible use of these devices is as yet unclear. However, organized training sessions have resulted in modest agreement with standard echocardiography and point-of-care echocardiography performed by expert echocardiographers. It is conceivable that the hand-carried echocardiographic devices will be used in medical school curriculum to enhance medical student education in the future.
在过去几十年里，体格检查技能一直在下降，而技术却使诊断测试变得越来越复杂。对于心血管疾病患者来说，床边诊断的最佳方法是在接触患者时将体格检查和随时可用的技术相结合。由于设备尺寸和这些测试的时间限制，大多数心脏检查并非在床边进行。现在有小型手持式超声心动图设备可用于快速床边检查。当在心脏病门诊环境以及非危重症住院患者中使用时，这些设备与全功能系统相比效果良好。与经过委员会认证的心脏病专家进行的体格检查相比，这些设备减少了诊断错误。体格检查后早期使用手持式超声心动图设备已被证明会影响患者的分诊和治疗，以及发现其他未被检测到的心脏疾病。负责任地使用这些设备所需的培训程度尚不清楚。然而，有组织的培训课程已使结果与专家超声心动图医生进行的标准超声心动图和即时超声心动图有适度的一致性。可以想象，手持式超声心动图设备未来将用于医学院课程，以加强医学生教育。
