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肺部超声:一项针对心脏康复病房收治患者的叙述性综述和建议方案。

Lung ultrasound: a narrative review and proposed protocol for patients admitted to Cardiac Rehabilitation Unit.

机构信息

Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University Hospital, Naples.

Hypertension Research Center & Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy.

出版信息

Monaldi Arch Chest Dis. 2021 Aug 23;92(1). doi: 10.4081/monaldi.2021.1753.

DOI:10.4081/monaldi.2021.1753
PMID:34461698
Abstract

Lung ultrasonography (LUS) has become in the last 10 years a technique that has reduced the need of second level diagnostic methods such as chest X-ray (CXR) and computerize tomography (CT) for the diagnostic imaging of lung and pleural space, throughout its diagnostic accuracy, radiation free, low cost, real time and bedside approach. The common use of LUS has been recently extend to cardiac and pulmonary disease even in context of Cardiac Rehabilitation Unit and it could be an additional tool for physiotherapist for the management of patients during Rehabilitation course. The authors performed a literature review in PubMed and suggested a new standardize protocol for LUS, based on guidelines and expert consensus document, for patients admitted to Cardiac Rehabilitation Unit. In this protocol, LUS should be performed in six scan each hemithorax, covering twelve imagine regions. For each scan will be noted a specific physiologic or pathological patterns. Furthermore, we suggest for each patient, the use of the Lung Ultrasound Score (LUS score) to obtain a global view of lung aeration and to monitor any changes during the hospitalization. An increase in score range indicates a more severe condition. This Lung Ultrasonography Protocol should be performed in all patients at the time of admission to Cardiac Rehabilitation Unit to monitoring the aeration of the lungs and the possible lung and/or pleura complications after a cardiac disease avoiding the use of second level surveys.

摘要

在过去的 10 年中,超声肺检查(LUS)已成为一种技术,通过其诊断准确性、无辐射、低成本、实时和床边方法,减少了对胸部 X 线(CXR)和计算机断层扫描(CT)等二级诊断方法对肺部和胸膜空间进行诊断成像的需求。LUS 的常规使用最近已扩展到心脏和肺部疾病,即使在心脏康复单元的背景下也是如此,它也可以成为物理治疗师在康复过程中管理患者的额外工具。作者在 PubMed 上进行了文献回顾,并根据指南和专家共识文件,为心脏康复单元收治的患者制定了新的 LUS 标准化方案。在该方案中,应在每个半胸部进行六次扫描,共涵盖十二个想象区域。对于每个扫描,将记录特定的生理或病理模式。此外,我们建议为每位患者使用肺部超声评分(LUS 评分)来获得肺部充气的整体视图,并在住院期间监测任何变化。评分范围的增加表明病情更严重。该肺部超声检查方案应在心脏康复单元收治的所有患者中进行,以监测肺部充气情况,并在心脏疾病后可能发生的肺部和/或胸膜并发症,避免使用二级调查。

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