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[斑点追踪超声心动图——重症监护病房的一种新工具?]

[Speckle Tracking Echocardiography - a New Tool for the Intensive Care Unit?].

作者信息

Reckefuß Norbert, Heuer Jan Florian, Butz Thomas

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2019 May;54(5):356-363. doi: 10.1055/s-0043-120553. Epub 2019 May 13.

Abstract

The noninvasive evaluation of cardiac morphology and function by echocardiography is an essential part of modern intensive care therapy. However, this procedure can be challenging and beginners often lack the ability to objectively state the correct global and regional myocardial function. Recent developments allow a semi-automatic deformation (strain) analysis by a couple of more objective respective parametric techniques. Strain describes the change in length of a myocardial segment during the cardiac cycle. While this is primarily a regional analysis, an insight into the global left ventricular deformation is possible by averaging all relevant segments. Speckle tracking echocardiography (STE) is actually the only clinically relevant technique and is well scientifically and clinically approved. The advantages of STE are the angle-independency, the ease and fastness of its use, the availability at the bedside and low costs. Through proven good reproducibility it should be a good method for repeated analysis even by different echocardiographers. However, actually the greatest disadvantage is the variation of measures between different vendors of ultrasound machines and software-packages. At the moment, a task force of leading echocardiography experts and industry personal is working on a solution. Normal values have been published for healthy collectives and STE has been in use in the majority of cardiac diseases. Besides from a few research studies, the usage in critically ill patients actually is still limited.

摘要

超声心动图对心脏形态和功能进行无创评估是现代重症监护治疗的重要组成部分。然而,该操作可能具有挑战性,初学者往往缺乏客观描述正确的整体和局部心肌功能的能力。最近的进展使得通过一些更客观的参数技术进行半自动变形(应变)分析成为可能。应变描述了心动周期中心肌节段长度的变化。虽然这主要是一种局部分析,但通过对所有相关节段进行平均,可以深入了解左心室整体变形情况。斑点追踪超声心动图(STE)实际上是唯一具有临床相关性的技术,并且在科学和临床上都得到了充分认可。STE的优点包括角度独立性、使用简便快捷、床边可用以及成本低。由于其良好的可重复性已得到证实,即使由不同的超声心动图检查人员进行重复分析,它也应该是一种很好的方法。然而,实际上最大的缺点是不同超声机器和软件包供应商之间测量结果存在差异。目前,一个由领先的超声心动图专家和行业人员组成的特别工作组正在努力解决这个问题。已公布了健康人群的正常值,STE已应用于大多数心脏病。除了一些研究之外,其在危重症患者中的应用实际上仍然有限。

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