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肾脏病学中的床旁超声检查:不断增加的应用、误解及未来展望。

Point-of-care ultrasonography in nephrology: Growing applications, misconceptions and future outlook.

作者信息

Diniz Hugo, Ferreira Filipa, Koratala Abhilash

机构信息

Department of Nephrology, Centro Hospitalar E Universitário De São João, Porto 4200-319, Portugal.

Division of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, United States.

出版信息

World J Nephrol. 2025 Jun 25;14(2):105374. doi: 10.5527/wjn.v14.i2.105374.

Abstract

Ultrasound has long been an essential tool in nephrology, traditionally used for procedures like vascular access and kidney biopsies. Point-of-care ultrasonography (POCUS), a rapidly evolving bedside technology, is now gaining momentum in nephrology by providing real-time imaging to enhance physical examination findings. Unlike comprehensive radiology-performed ultrasound, POCUS focuses on specific clinical questions, providing immediate and actionable insights. This narrative review examines the philosophy behind POCUS, its expanding applications in nephrology, and its impact on patient care, including its role in diagnosing obstructive uropathy, guiding fluid management, and evaluating hemodynamics in cardiorenal syndrome. Additionally, the review addresses barriers to widespread adoption, such as the need for structured training, competency validation, and interdisciplinary cooperation. By integrating POCUS into routine practice, nephrologists can refine diagnostic accuracy, improve patient outcomes, and strengthen the role of bedside medicine.

摘要

长期以来,超声一直是肾脏病学中的一项重要工具,传统上用于血管通路建立和肾活检等操作。床旁即时超声检查(POCUS)是一项快速发展的床旁技术,通过提供实时成像以增强体格检查结果,目前在肾脏病学领域正获得越来越多的关注。与放射科进行的全面超声检查不同,POCUS专注于特定的临床问题,提供即时且可采取行动的见解。本叙述性综述探讨了POCUS背后的理念、其在肾脏病学中不断扩展的应用,以及它对患者护理的影响,包括其在诊断梗阻性尿路病、指导液体管理和评估心肾综合征血流动力学方面的作用。此外,该综述还讨论了广泛采用POCUS的障碍,如需要结构化培训、能力验证和跨学科合作。通过将POCUS整合到常规实践中,肾病学家可以提高诊断准确性,改善患者预后,并加强床旁医学的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81f6/12001222/086e5617f48e/105374-g001.jpg

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