Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Naval Hospital Jacksonville, Jacksonville, FL, USA.
Am Fam Physician. 2020 Mar 1;101(5):275-285.
Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. POCUS confirmation of intrauterine pregnancy rules out an ectopic pregnancy. In the third trimester of high-risk pregnancies, umbilical artery Doppler ultrasonography can improve perinatal outcomes. Musculoskeletal POCUS is used to diagnose and guide treatment of many joint and soft tissue conditions. It is as accurate as magnetic resonance imaging in the diagnosis of complete rotator cuff tears. Ultrasound guidance improves outcomes in the placement of central venous catheters and fluid drainage from body cavities and lumbar punctures. Ultrasonography can reduce the use of CT for diagnosis of appendicitis; however, negative scan results do not rule out disease. POCUS can accurately diagnose and rule out gallbladder pathology, and is effective for diagnosing urolithiasis. Focused cardiac ultrasonography can detect pericardial effusion and decreased systolic function, but is less accurate than lung ultrasonography at diagnosing acute heart failure. Limited evidence demonstrates a benefit of diagnosing testicular and gynecologic conditions. The American College of Emergency Physicians, the American Institute of Ultrasound in Medicine, the Society for Academic Emergency Medicine, the American College of Radiology, and others offer POCUS training. Training standards for POCUS have been defined for residency programs but are less established for credentialing.
床旁即时超声检查（POCUS）由医师在床边进行，是妇产科、急诊和肌肉骨骼医学的标准实践。与正式超声检查相比，POCUS 在筛查腹主动脉瘤和诊断深静脉血栓形成方面具有同等的准确性。POCUS 在诊断肺炎和检测急性失代偿性心力衰竭方面具有很高的准确性，但在识别肺栓塞方面不如计算机断层扫描准确。POCUS 对宫内妊娠的确认可以排除宫外孕。在高危妊娠的第三个 trimester，脐动脉多普勒超声检查可以改善围产期结局。肌肉骨骼 POCUS 用于诊断和指导许多关节和软组织疾病的治疗。它在诊断完全肩袖撕裂方面与磁共振成像一样准确。超声引导可改善中心静脉导管和体腔及腰椎穿刺液引流的置管效果。超声检查可减少 CT 对阑尾炎的诊断；然而，阴性扫描结果并不能排除疾病。POCUS 可以准确诊断和排除胆囊病变，并有效诊断尿路结石。心脏焦点超声检查可检测心包积液和收缩功能降低，但在诊断急性心力衰竭方面不如肺部超声检查准确。有限的证据表明，诊断睾丸和妇科疾病有一定的益处。美国急诊医师学院、美国超声医学学会、学术急诊医学学会、美国放射学会等提供 POCUS 培训。POCUS 培训标准已为住院医师培训计划所定义，但在认证方面的基础还不够扎实。
