Hospital da Luz, Cardiology Department, Lisbon, Portugal.
J Am Soc Echocardiogr. 2011 Feb;24(2):117-24. doi: 10.1016/j.echo.2010.09.017. Epub 2010 Nov 12.
The aim of this study was to assess the usefulness of a new miniaturized echocardiographic system (MS) to perform bedside echocardiography in initial outpatient cardiology consultations, in addition to physical examination.
One hundred eighty-nine patients referred for initial cardiology outpatient consultations at two tertiary hospitals in two countries were studied. Each patient was submitted to physical examination followed by MS assessment. Scanning time, the number of examinations with abnormal results after physical examination and the MS, and the information obtained by physical examination alone and followed by the MS (in terms of its importance in reaching a diagnosis, in the necessity of performing routine echocardiography, and in the decision to release the patient from the outpatient clinic) were assessed.
The scanning time with the MS was 180 ± 86 seconds. Its use after physical examination led to diagnoses in 141 patients (74.6%) and to an additional 37 patients (19.6%) being released from the outpatient clinic. After physical examination followed by MS assessment, only 64 patients (33.9%) were sent to the echocardiography lab. The MS modified the decision of whether to send a patient to the echocardiography lab, with referral determined by the MS in 27 patients (14.3%) and no referral determined by the MS in 58 patients (30.7%).
The new MS caused a negligible increase in the duration of consultations. It showed additive clinical value over physical examination, increasing the number of diagnoses, reducing the use of unnecessary routine echocardiography, increasing the number of adequate echocardiographic studies, and determining a large number of releases from the outpatient clinic.
本研究旨在评估一种新型微型超声心动图系统（MS）在除体格检查之外，在初始门诊心内科会诊中进行床旁超声心动图检查的实用性。
研究共纳入在两个国家的两家三级医院就诊的 189 例初始心内科门诊患者。每位患者均先接受体格检查，再接受 MS 评估。评估体格检查后单独使用 MS 和联合使用 MS（在做出诊断、是否需要进行常规超声心动图检查以及决定是否将患者从门诊转至心内科病房方面）的重要性）时，评估检查时间、体格检查和 MS 后异常结果的检查次数，以及获得的信息。
MS 的扫描时间为 180±86 秒。体格检查后使用 MS 可使 141 例患者（74.6%）得到诊断，并使 37 例患者（19.6%）从门诊转至心内科病房。体格检查后再行 MS 评估，仅 64 例患者（33.9%）被转至超声心动图检查室。MS 改变了是否将患者转至超声心动图检查室的决定，MS 决定转诊 27 例患者（14.3%），MS 决定不转诊 58 例患者（30.7%）。
新型 MS 仅略微增加了会诊时间。它在体格检查的基础上增加了附加的临床价值，增加了诊断数量，减少了不必要的常规超声心动图检查的使用，增加了充分的超声心动图检查数量，并使大量患者从门诊转至心内科病房。
