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血液还是脂肪？使用心脏聚焦超声鉴别心包积血与心外膜脂肪。

Blood or Fat? Differentiating Hemopericardium versus Epicardial Fat Using Focused Cardiac Ultrasound.

作者信息

Bronshteyn Yuriy S, Hashmi Nazish, Privratsky Jamie R, Barbeito Atilio

机构信息

Duke University Health System, Duke University School of Medicine, Durham, NC 27710, USA.

Durham Veterans Health Administration, Durham, NC 27705, USA.

出版信息

Diagnostics (Basel). 2024 Apr 15;14(8):818. doi: 10.3390/diagnostics14080818.

DOI:10.3390/diagnostics14080818
PMID:38667464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11049036/
Abstract

Basic point-of-care ultrasound of the heart-also known as Focused Cardiac Ultrasound (FoCUS)-has emerged as a powerful bedside tool to narrow the differential diagnosis of causes of hypotension. The list of causes of hypotension that a FoCUS provider is expected to be able to recognize includes a compressive pericardial effusion due to hemopericardium (blood in the pericardial sac). But hemopericardium can be difficult to distinguish from a more common condition that is not immediately life-threatening: epicardial fat. This paper reviews illustrative images of both epicardial fat and hemopericardium to provide practice guidance to the FoCUS user on how to differentiate these two phenomena.

摘要

心脏床旁基本超声检查——也称为心脏聚焦超声（FoCUS）——已成为一种强大的床旁工具，用于缩小低血压病因的鉴别诊断范围。FoCUS检查人员应能够识别的低血压病因包括因心包积血（心包腔内有血液）导致的压迫性心包积液。但心包积血可能难以与一种更常见且不会立即危及生命的情况区分开来：心外膜脂肪。本文回顾了心外膜脂肪和心包积血的示例图像，为FoCUS使用者提供关于如何区分这两种现象的实践指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/a361b42f9501/diagnostics-14-00818-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/34d287780b5e/diagnostics-14-00818-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/a0e521d995f4/diagnostics-14-00818-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/88ed0d4dedc7/diagnostics-14-00818-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/a361b42f9501/diagnostics-14-00818-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/34d287780b5e/diagnostics-14-00818-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/a0e521d995f4/diagnostics-14-00818-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/88ed0d4dedc7/diagnostics-14-00818-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f7/11049036/a361b42f9501/diagnostics-14-00818-g004.jpg

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本文引用的文献

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Ultrasound Guidelines: Emergency, Point-of-Care, and Clinical Ultrasound Guidelines in Medicine.超声指南：医学中的急诊、床旁及临床超声指南
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Comparison of qualitative information obtained with the echocardiographic assessment using subcostal-only view and focused transthoracic echocardiography examinations: a prospective observational study.经肋缘下切面超声心动图评估与经胸聚焦超声心动图检查获取定性信息的比较：一项前瞻性观察研究。
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Diagnostic Point-of-Care Ultrasound: Recommendations From an Expert Panel.即时诊断床边超声：专家小组的建议。
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American Society of Regional Anesthesia and Pain Medicine expert panel recommendations on point-of-care ultrasound education and training for regional anesthesiologists and pain physicians-part I: clinical indications.美国区域麻醉与疼痛医学学会专家组关于区域麻醉医师和疼痛医师即时超声教育和培训的建议-第一部分：临床适应证。
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American Society of Regional Anesthesia and Pain Medicine expert panel recommendations on point-of-care ultrasound education and training for regional anesthesiologists and pain physicians-part II: recommendations.美国区域麻醉与疼痛医学学会专家组关于区域麻醉医师和疼痛医师即时超声教育与培训的建议——第二部分：建议。
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