Tinè Mariaenrica, Daverio Matteo, Semenzato Umberto, Cocconcelli Elisabetta, Bernardinello Nicol, Damin Marco, Saetta Marina, Spagnolo Paolo, Balestro Elisabetta
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.
Front Med (Lausanne). 2023 Oct 11;10:1289221. doi: 10.3389/fmed.2023.1289221. eCollection 2023.
Thoracic ultrasound (TUS) has become an essential procedure in respiratory medicine. Due to its intrinsic safety and versatility, it has been applied in patients affected by several respiratory diseases both in intensive care and outpatient settings. TUS can complement and often exceed stethoscope and radiological findings, especially in managing pleural diseases. We hereby aimed to describe the establishment, development, and optimization in a large, tertiary care hospital of a pleural clinic, which is dedicated to the evaluation and monitoring of patients with pleural diseases, including, among others, pleural effusion and/or thickening, pneumothorax and subpleural consolidation. The clinic was initially meant to follow outpatients undergoing medical thoracoscopy. In this scenario, TUS allowed rapid and regular assessment of these patients, promptly diagnosing recurrence of pleural effusion and other complications that could be appropriately managed. Over time, our clinic has rapidly expanded its initial indications thus becoming the place to handle more complex respiratory patients in collaboration with, among others, thoracic surgeons and oncologists. In this article, we critically describe the strengths and pitfalls of our "pleural clinic" and propose an organizational model that results from a synergy between respiratory physicians and other professionals. This model can inspire other healthcare professionals to develop a similar organization based on their local setting.
胸部超声（TUS）已成为呼吸医学中的一项重要检查手段。由于其固有的安全性和多功能性，它已被应用于重症监护和门诊环境中受多种呼吸系统疾病影响的患者。TUS可以补充并常常超越听诊器和影像学检查结果，尤其是在胸膜疾病的管理方面。我们在此旨在描述一家大型三级医院胸膜诊所的建立、发展和优化情况，该诊所致力于评估和监测胸膜疾病患者，包括胸腔积液和/或增厚、气胸和胸膜下实变等。该诊所最初旨在随访接受内科胸腔镜检查的门诊患者。在这种情况下，TUS能够对这些患者进行快速且定期的评估，及时诊断胸腔积液复发及其他可得到妥善处理的并发症。随着时间的推移，我们的诊所迅速扩大了其最初的适应症范围，从而成为与胸外科医生和肿瘤学家等合作处理更复杂呼吸系统患者的场所。在本文中，我们批判性地描述了我们“胸膜诊所”的优势和缺陷，并提出了一种由呼吸内科医生与其他专业人员协同合作产生的组织模式。这种模式可以启发其他医疗保健专业人员根据当地情况建立类似的组织。
