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[基础肺部超声。第1部分。正常肺部超声及胸壁和胸膜疾病]

[Basic lung ultrasound. Part 1. Normal lung ultrasound and diseases of the chest wall and the pleura].

作者信息

de la Quintana Gordon F B, Nacarino Alcorta B

机构信息

Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Hospital Universitario de Móstoles, Madrid, España.

Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Hospital Universitario de Móstoles, Madrid, España.

出版信息

Rev Esp Anestesiol Reanim. 2015 Jun-Jul;62(6):322-36. doi: 10.1016/j.redar.2015.02.003. Epub 2015 Apr 15.

Abstract

Lung ultrasound has become part of the diagnostic armamentarium in Resuscitation and Recovery Units with an enormous potential due to its many advantages: capacity to diagnose more precisely than conventional radiology, earlier diagnosis, convenience due to being able to performed at the bedside, possibility of being performed by one person, absence of ionising radiation, and, due to its dynamic character, is capable of transforming into physiological processes that were once static images. However, lung ultrasound also has its limitations and has a learning curve. The aim of this review is to provide sufficient information that may help the specialist starting in this field to approach the technique with good possibilities of success. To do this, the review is structured into two parts. In the first, the normal ultrasound of the chest wall is presented, as well as the pleura, diaphragm, and lung parenchyma, and the most important pathologies of the chest wall (rib fractures and hematomas), the pleura (pleural effusion and its different types, and pneumothorax), and the diaphragm (hypokinesia and paralysis). In the second part, parenchymal diseases will be approached and will include, atelectasis, pneumonia and abscess, lung oedema, respiratory distress, and pulmonary thromboembolism.

摘要

肺部超声已成为复苏和康复单元诊断手段的一部分,因其具有诸多优势而具有巨大潜力:诊断比传统放射学更精确、能更早诊断、因可在床边进行而方便、可由一人操作、无电离辐射,并且由于其动态特性,能够将曾经的静态图像转化为生理过程。然而,肺部超声也有其局限性且存在学习曲线。本综述的目的是提供足够信息,帮助该领域的新手专家以较高的成功可能性掌握这项技术。为此,综述分为两部分。第一部分介绍胸壁、胸膜、膈肌和肺实质的正常超声表现,以及胸壁的最重要病变(肋骨骨折和血肿)、胸膜病变(胸腔积液及其不同类型和气胸)和膈肌病变(运动减退和麻痹)。第二部分将探讨实质疾病,包括肺不张、肺炎和肺脓肿、肺水肿、呼吸窘迫和肺血栓栓塞。

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