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由急诊医生进行的连续床旁超声心动图检查以指导大面积肺栓塞的溶栓治疗管理。

Serial Point-of-care Echocardiography Performed by an Emergency Physician to Guide Thrombolytic Management of Massive Pulmonary Embolism.

作者信息

Au Annie, Hsu Patrick, McClure Matthew, Cabrera Gabriel, Kalivoda Eric J

机构信息

Emergency Medicine, Hospital Corporation of America West Florida GME Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA.

出版信息

Cureus. 2020 Apr 21;12(4):e7771. doi: 10.7759/cureus.7771.

DOI:10.7759/cureus.7771
PMID:32461847
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7243659/
Abstract

Massive pulmonary embolism (PE) is a life-threatening condition with a high mortality burden. The rapid diagnosis of PE can be supported with focused cardiac ultrasound (FOCUS) by identifying signs of right ventricular dysfunction (RVD). This case report describes a patient with hemodynamically unstable massive PE who received systemic thrombolytic therapy. Emergency physicians performed serial FOCUS examinations to assess the resolution of RVD in guidance of clinical management.

摘要

大面积肺栓塞（PE）是一种危及生命的疾病，具有很高的死亡负担。通过识别右心室功能障碍（RVD）的体征，心脏聚焦超声（FOCUS）有助于快速诊断PE。本病例报告描述了一名血流动力学不稳定的大面积PE患者接受了全身溶栓治疗。急诊医生进行了系列FOCUS检查，以评估RVD的缓解情况，为临床管理提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/8b64208312e9/cureus-0012-00000007771-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/59056d705985/cureus-0012-00000007771-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/925c04e9660a/cureus-0012-00000007771-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/232c0589d92d/cureus-0012-00000007771-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/410b669855af/cureus-0012-00000007771-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/dc22a11729ba/cureus-0012-00000007771-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/8f831ee74aeb/cureus-0012-00000007771-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/fbcdaab82d49/cureus-0012-00000007771-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/6915eeb66cf1/cureus-0012-00000007771-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/994a91b4611b/cureus-0012-00000007771-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/8b64208312e9/cureus-0012-00000007771-i10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/59056d705985/cureus-0012-00000007771-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/925c04e9660a/cureus-0012-00000007771-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/232c0589d92d/cureus-0012-00000007771-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/410b669855af/cureus-0012-00000007771-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/dc22a11729ba/cureus-0012-00000007771-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/8f831ee74aeb/cureus-0012-00000007771-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/fbcdaab82d49/cureus-0012-00000007771-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/6915eeb66cf1/cureus-0012-00000007771-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/994a91b4611b/cureus-0012-00000007771-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ec/7243659/8b64208312e9/cureus-0012-00000007771-i10.jpg

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本文引用的文献

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2
Increased Sensitivity of Focused Cardiac Ultrasound for Pulmonary Embolism in Emergency Department Patients With Abnormal Vital Signs.异常生命体征的急诊科患者中，焦点式心脏超音波对肺栓塞的敏感度增加。
Acad Emerg Med. 2019 Nov;26(11):1211-1220. doi: 10.1111/acem.13774. Epub 2019 Sep 27.
3
Tricuspid annular plane of systolic excursion to prognosticate acute pulmonary symptomatic embolism (TAPSEPAPSE study).
三尖瓣环收缩期位移平面预测急性肺栓塞症状（TAPSEPAPSE研究）
J Ultrasound Med. 2019 Mar;38(3):695-702. doi: 10.1002/jum.14753. Epub 2018 Sep 4.
4
Successful Point-Of-Care Ultrasound-Guided Treatment of Submassive Pulmonary Embolism.床旁超声引导下成功治疗亚大面积肺栓塞
Clin Pract Cases Emerg Med. 2017 Oct 6;1(4):340-344. doi: 10.5811/cpcem.2017.7.34504. eCollection 2017 Nov.
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