Emergency Medicine Ultrasound Division, Massachusetts General Hospital, Suite 140, 5 Emerson Place, Boston, MA 02114, USA.
Emerg Med J. 2013 Jan;30(1):3-8. doi: 10.1136/emermed-2012-201375. Epub 2012 Jun 8.
Renal colic is a common emergency department (ED) presentation. The use of CT in the diagnosis of renal colic has increased over the past two decades and is now the most common imaging modality used in many institutions. However, with growing concerns about cumulative radiation exposure, increasing healthcare costs and patient flow in EDs, alternative approaches may need to be considered. Point-of-care ultrasound may offer a radiation-free, rapid and cost-effective alternative. The authors reviewed the literature and synthesised some of the data comparing point-of-care ultrasound with CT scanning as well as some of the evidence for how it might be incorporated into a renal colic management strategy. It is concluded that there is enough evidence to define a rational algorithm for renal colic management. A prospectively validated algorithm would greatly assist primary care and emergency practitioners while reducing costs and radiation dose.
肾绞痛是急诊科常见的急症。在过去的二十年中，CT 在肾绞痛的诊断中得到了广泛应用，现在已成为许多医疗机构中最常用的影像学检查方法。然而，由于人们越来越关注累积辐射暴露、不断上涨的医疗保健成本以及急诊科的患者流量，可能需要考虑替代方法。即时超声检查可能提供一种无辐射、快速且具有成本效益的替代方法。作者回顾了文献，并综合了一些比较即时超声检查与 CT 扫描的研究数据，以及一些关于即时超声检查如何纳入肾绞痛管理策略的证据。结论是，有足够的证据可以确定一种合理的肾绞痛管理算法。经过前瞻性验证的算法将极大地帮助初级保健和急诊医生，同时降低成本和辐射剂量。
