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重症监护病房胸腔积液的超声检查:从诊断到治疗的叙述性综述。

Thoracic ultrasound for pleural effusion in the intensive care unit: a narrative review from diagnosis to treatment.

机构信息

Department of Anaesthesia and Intensive Care, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Institute of Clinical Physiology, National Research Council, Pisa, Italy.

出版信息

Crit Care. 2017 Dec 28;21(1):325. doi: 10.1186/s13054-017-1897-5.

Abstract

Pleural effusion (PLEFF), mostly caused by volume overload, congestive heart failure, and pleuropulmonary infection, is a common condition in critical care patients. Thoracic ultrasound (TUS) helps clinicians not only to visualize pleural effusion, but also to distinguish between the different types. Furthermore, TUS is essential during thoracentesis and chest tube drainage as it increases safety and decreases life-threatening complications. It is crucial not only during needle or tube drainage insertion, but also to monitor the volume of the drained PLEFF. Moreover, TUS can help diagnose co-existing lung diseases, often with a higher specificity and sensitivity than chest radiography and without the need for X-ray exposure. We review data regarding the diagnosis and management of pleural effusion, paying particular attention to the impact of ultrasound. Technical data concerning thoracentesis and chest tube drainage are also provided.

摘要

胸腔积液(PLEFF)主要由容量超负荷、充血性心力衰竭和胸膜肺部感染引起,是重症监护患者的常见病症。胸腔超声(TUS)不仅有助于临床医生观察胸腔积液,还能区分不同类型的胸腔积液。此外,在进行胸腔穿刺和胸管引流时,TUS 至关重要,因为它可以提高安全性并减少危及生命的并发症。TUS 在针或管引流插入过程中不仅至关重要,而且对于监测引流的胸腔积液量也很重要。此外,TUS 可以帮助诊断同时存在的肺部疾病,其特异性和敏感性通常高于胸部 X 线摄影,而且无需 X 射线暴露。我们回顾了关于胸腔积液诊断和管理的数据,特别关注超声的影响。还提供了有关胸腔穿刺和胸管引流的技术数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e565/5745967/293e2bb025f7/13054_2017_1897_Fig1_HTML.jpg

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