Dougherty J E, LaSala A F, Fieldman A
Chest. 1980 Jan;77(1):43-6. doi: 10.1378/chest.77.1.43.
A single view, wedge, pulmonary angiogram was performed at bedside in nine patients using a Swan-Ganz catheter which had been inserted previously for other indications. Criteria for consideration of a bedside study were as follows: (1) a clinical suspicion of significant, acute pulmonary embolism; (2) the inability or inadvisability of transferring the patient for definitive studies; and (3) a Swan-Ganz catheter in situ. Seven of the nine patients subsequently died. Of five patients who underwent necropsy, three positive studies and one negative, were confirmed. No post-mortem evidence for embolism could be demonstrated in one patient with a positive study. Of the two patients who survived, one negative study was confirmed with a negative radionuclide perfusion lung scan. There was no morbidity or mortality associated with the procedure. These data suggest that this technique is safe and has a role in the early diagnosis of significant pulmonary embolism in selected critically ill patient.
对9例患者在床边采用Swan - Ganz导管进行了单次楔形肺血管造影，这些患者此前已因其他指征插入该导管。考虑进行床边检查的标准如下：（1）临床怀疑存在严重急性肺栓塞；（2）患者无法或不适合转至其他地方进行确定性检查；（3）Swan - Ganz导管已在原位。9例患者中有7例随后死亡。在接受尸检的5例患者中，3例检查结果阳性，1例阴性，均得到证实。1例检查结果阳性的患者在尸检中未发现栓塞证据。在2例存活患者中，1例检查结果阴性，经放射性核素灌注肺扫描证实。该操作未导致任何并发症或死亡。这些数据表明，这项技术是安全的，在某些危重症患者重大肺栓塞的早期诊断中具有一定作用。
