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床旁超声在急性呼吸困难支气管镜检查前评估中的应用:一例合并大面积肺栓塞和深静脉血栓形成的病例

Point-of-care ultrasound in pre-bronchoscopy assessment of acute dyspnea: A case of concurrent massive pulmonary embolism and deep vein thrombosis.

作者信息

Ahmad Mohammad Amirul Shahril Bin, Nyanti Larry Ellee, Yeoh Jie Cong, A Hing Chan Tha, Chai Chan Sin, Tie Siew Teck

机构信息

Division of Respiratory Medicine, Department of Medicine Sarawak General Hospital Kuching Malaysia.

Department of Medicine, Faculty of Medicine and Health Sciences Universiti Malaysia Sabah Sabah Malaysia.

出版信息

Respirol Case Rep. 2022 Sep 7;10(10):e01029. doi: 10.1002/rcr2.1029. eCollection 2022 Oct.

Abstract

Point-of-care ultrasound (POCUS) leads to efficient real-time diagnosis in a wide range of medical specialties. We describe the use of cardiac, lung and lower limb POCUS to rapidly diagnose massive pulmonary embolism and deep vein thrombosis in a 64-year-old patient presenting with acute dyspnea prior to elective bronchoscopy. Left femoral vein thrombus and features of increased right heart pressure on POCUS led to the decision to administer fibrinolytic therapy, with subsequent CT pulmonary angiogram confirming bilateral PE. The use of POCUS allowed for rapid imaging and interpretation leading to a rapid diagnosis of PE, thus fast-tracking lifesaving anticoagulation, especially in an outpatient setting.

摘要

床旁超声(POCUS)能在广泛的医学专科中实现高效的实时诊断。我们描述了对一名64岁在择期支气管镜检查前出现急性呼吸困难的患者,使用心脏、肺部和下肢POCUS快速诊断大面积肺栓塞和深静脉血栓形成的情况。POCUS显示左股静脉血栓及右心压力升高的特征,促使决定给予纤溶治疗,随后的CT肺动脉造影证实了双侧肺栓塞。POCUS的使用实现了快速成像和解读,从而快速诊断肺栓塞,进而迅速启动挽救生命的抗凝治疗,尤其是在门诊环境中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0abf/9452440/2228fe77ea0a/RCR2-10-e01029-g001.jpg

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