Zicot M
Centre Hospitalier Universitaire, Service de Cardiologie, Sart Tilman, Liége.
Acta Chir Belg. 1988 May-Jun;88(3):169-74.
The history and the physical examination are important steps in the clinical approach to the polyvascular patient. They are the foundation of a rational diagnostic and therapeutic management. Complementary investigations are nevertheless necessary. Ultrasonography has become an essential complement to the physical examination. Its field covers all peripheral vessels: supra-aortic arteries, aorta and its branches, limb arteries. The ultrasound are applied following continuous and pulsed Doppler and real time echography. The two methods may be combined (duplex echography). The investigations are performed first at rest, but assessments under strain are often necessary. The cardiac examination has been enriched by modern methods: thallium scintigraphy under dipyridamole is specially useful in order to measure the coronary reserve. Angiographic images are still a must for most of the aggressive therapeutic decisions. The modern techniques are more flexible using digitalization and a suitable investigation is chosen in function of each individual condition.
病史和体格检查是多血管疾病患者临床诊疗过程中的重要步骤。它们是合理的诊断和治疗管理的基础。然而，辅助检查也是必要的。超声检查已成为体格检查的重要补充。其检查范围覆盖所有外周血管：主动脉弓上动脉、主动脉及其分支、肢体动脉。超声检查采用连续和脉冲多普勒以及实时超声成像技术。这两种方法可以结合使用（双功超声成像）。检查首先在静息状态下进行，但通常也需要进行负荷状态下的评估。现代方法丰富了心脏检查：双嘧达莫负荷铊闪烁显像对于测量冠状动脉储备特别有用。对于大多数积极的治疗决策而言，血管造影图像仍然是必需的。现代技术借助数字化更加灵活，并且根据个体情况选择合适的检查方法。
