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眼部即时超声评估在急诊环境中的应用:一项范围综述。

Applications of ocular point-of-care ultrasound assessment in the emergency setting: a scoping review.

作者信息

Yang Christopher D, Kim Christine K, Chang Melissa M, Khosravi Pooya, Bhatia Ajeet Pal Bayo, Santos Amanda Dos, Dornhofer Kyle, Guy Megan, Hsu Edmund, Saadat Soheil, Fox John Christian

机构信息

Department of Emergency Medicine, University of California, Irvine, Orange, CA, USA.

School of Medicine, University of California, Irvine, Orange, CA, USA.

出版信息

Clin Exp Emerg Med. 2025 Sep;12(3):188-197. doi: 10.15441/ceem.24.249. Epub 2024 Sep 6.

DOI:10.15441/ceem.24.249
PMID:39237139
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12541526/
Abstract

OBJECTIVE

To evaluate the current body of literature pertaining to the use of ocular point-of-care ultrasound (POCUS) in the emergency department (ED).

METHODS

A comprehensive literature search was conducted on Scopus, Web of Science, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Inclusion criteria were studies written in English and primary clinical studies involving ocular POCUS scans in an ED setting. Exclusion criteria were nonprimary studies (e.g., reviews or case reports), studies written in a non-English language, nonhuman studies, studies performed in a nonemergency setting, studies involving non-POCUS ocular ultrasound modalities, or studies published more than 10 years prior. Data extraction was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations.

RESULTS

The initial search yielded 391 results with 153 duplicates. Of the remaining 238 studies selected for retrieval and screening, 24 met the inclusion criteria. These 24 included studies encompassed 2,448 patients across prospective, retrospective, cross-sectional, and case series study designs. The majority of included studies focused on the use of POCUS in the ED to measure optic nerve sheath diameter as a proxy for papilledema and metabolic aberrations, while a minority of studies used ocular POCUS to assist in the diagnosis of orbital fractures or posterior segment pathology.

CONCLUSION

The vast majority of studies investigating the use of ocular POCUS in recent years emphasize its utility in measuring optic nerve sheath diameter and fluctuations in intracranial pressure, though additional outcomes of interest include pathology of the posterior segment, orbit, and globe.

摘要

目的

评估目前有关急诊科使用眼部即时超声(POCUS)的文献。

方法

在Scopus、科学网、MEDLINE和Cochrane对照试验中央注册库(CENTRAL)数据库中进行了全面的文献检索。纳入标准为用英文撰写的研究以及涉及急诊科眼部POCUS扫描的原发性临床研究。排除标准为非原发性研究(如综述或病例报告)、非英文撰写的研究、非人体研究、在非急诊环境中进行的研究、涉及非POCUS眼部超声模式的研究或发表超过10年的研究。数据提取以PRISMA(系统评价和Meta分析的首选报告项目)建议为指导。

结果

初步检索产生了391条结果,其中153条重复。在其余238项选定进行检索和筛选的研究中,24项符合纳入标准。这24项纳入研究涵盖了前瞻性、回顾性、横断面和病例系列研究设计的2448例患者。大多数纳入研究聚焦于在急诊科使用POCUS测量视神经鞘直径以作为视乳头水肿和代谢异常的替代指标,而少数研究使用眼部POCUS协助诊断眼眶骨折或后段病变。

结论

近年来,绝大多数研究眼部POCUS应用的研究强调了其在测量视神经鞘直径和颅内压波动方面的效用,不过其他感兴趣的结果还包括后段、眼眶和眼球的病变。

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本文引用的文献

1
Sonographic Optic Nerve Sheath Diameter as a Guide for Correction of Hyponatremia in the Emergency Department: A Cross-sectional Study.超声视神经鞘直径作为急诊科低钠血症纠正指导:一项横断面研究。
Indian J Crit Care Med. 2023 Apr;27(4):265-269. doi: 10.5005/jp-journals-10071-24438.
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Diagnostic Accuracy of Ocular Ultrasonography in Identifying Raised Intracranial Pressure among Pediatric Population.眼部超声检查在识别儿科人群颅内压升高中的诊断准确性。
Pediatr Neurosurg. 2023;58(3):142-149. doi: 10.1159/000530921. Epub 2023 May 5.
3
The Role of Ultrasound in Pediatric Skull Fractures: Determination of Fracture and Optic Nerve Sheath Diameter Measurements.超声在小儿颅骨骨折中的作用:骨折的确定和视神经鞘直径测量。
Pediatr Emerg Care. 2023 Feb 1;39(2):91-97. doi: 10.1097/PEC.0000000000002895. Epub 2023 Jan 9.
4
The evaluation of intracranial pressure evaluation by optic nerve sheath diameter measurement on bedside ultrasonography after ischemic stroke.缺血性脑卒中后床旁超声视神经鞘直径测量评估颅内压。
Clin Neurol Neurosurg. 2021 Oct;209:106914. doi: 10.1016/j.clineuro.2021.106914. Epub 2021 Aug 28.
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Point-of-Care Ultrasound Findings in Multisystem Inflammatory Syndrome in Children: A Cross-Sectional Study.儿童多系统炎症综合征的即时超声检查结果:一项横断面研究。
Pediatr Emerg Care. 2021 Jun 1;37(6):334-339. doi: 10.1097/PEC.0000000000002410.
6
Bedside sonographic measurements of optic nerve sheath diameter in children with diabetic ketoacidosis.儿童糖尿病酮症酸中毒患者视神经鞘直径的床边超声测量。
Pediatr Diabetes. 2021 Jun;22(4):618-624. doi: 10.1111/pedi.13188. Epub 2021 Feb 16.
7
Novice emergency physician ultrasonography of optic nerve sheath diameter compared to ophthalmologist fundoscopic evaluation for papilledema.新手急诊医生对视神经鞘直径进行超声检查与眼科医生通过眼底镜检查评估视乳头水肿的比较。
J Am Coll Emerg Physicians Open. 2021 Jan 4;2(1):e12355. doi: 10.1002/emp2.12355. eCollection 2021 Feb.
8
Evaluation of Bedside Sonographic Measurement of Optic Nerve Sheath Diameter for Assessment of Raised Intracranial Pressure in Adult Head Trauma Patients.评估床旁超声测量视神经鞘直径在评估成年颅脑外伤患者颅内压升高方面的应用
J Emerg Trauma Shock. 2020 Jul-Sep;13(3):190-195. doi: 10.4103/JETS.JETS_94_19. Epub 2020 Sep 18.
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