Kushandiswa kweinotakurika ultrasound mune yakanyanya emergency emergency

Kushandiswa kweinotakurika ultrasound mune yakanyanya emergency emergency

Nekuenderera mberi kwekukura kwevanhu, kuongororwa kwe ultrasound kwave imwe yenzira dzinokosha dzekuongorora dzekuongororwa kwechiremba.Mukurapa kwekukurumidzira, inotakurika ultrasound kuongororwa ine hupamhi hwakasiyana, hwakanyanya kurongeka, kukurumidza kuongorora kukurumidza, kusakuvadza uye hakuna contraindication.Kudzokororwa kuongororwa kunogona kukurumidza kuongorora varwere mune chero mamiriro ezvinhu, kuhwina yakakosha nguva yekununura kune varwere vane kukuvara kwakanyanya kunouraya, uye kugadzirisa kushomeka kweX-rays.Kuongorora kwe X-ray;Kubatsira kukuru ndekwekuti varwere vekukurumidzira vane kutenderera kusingagadzike kana vasingafanirwe kufambiswa vanogona kuongororwa chero nguva uye chero kupi, uye hapana chinomisikidza chiitiko, inova ndiyo yekutanga nzira yekuongorora kune vanorwara zvakanyanya.

Mamiriro ekushandisa epamubhedha ultrasound kumba nekune dzimwe nyika

1. Kune zvakawanda uye zvakanyanya kudzidziswa ultrasound munyika.Parizvino, chirongwa chekutanga uye chinonzwisisika chekudzidzisa chakaumbwa, uye iyo World Intensive Ultrasound Alliance (WINFOCUS) yakasimbiswa.
2. The American College of Emergency Physicians inoda kuti varapi vekukurumidzira vanofanira kuziva teknolojia ye ultrasound yekukurumidza, uye 95% yenzvimbo 1 yekushungurudza nzvimbo muUnited States (190) vanoita emergency ultrasound.
3. Vanachiremba vekuEurope neJapan vakashandisa zvakanyanya ultrasound kubatsira varwere mukuongororwa uye kurapwa
4. China yakatanga kunonoka, asi kufambira mberi kunokurumidza.

Kushandiswa kweinotakurika ultrasound mukushungurudzika rubatsiro rwekutanga uye acute dumbu

01 Kuongorora kwekutanga
Kuongororwa kwehupenyu hunotyisidzira nzira yemhepo, kufema uye kutenderera.- Rubatsiro rwekutanga, emergency

02 Kuongorora kwechipiri
Ziva kukuvara kuri pachena munzvimbo dzese dzemuviri - emergency, ICU, wadhi

03 Cheki katatu
Yakazara yakarongeka yekuongorora kuti udzivise kurasikirwa nekushungurudzika -ICU, wadhi

Focus Ultrasound Ongororo yeTrauma (FAST):Mapoinzi matanhatu (subxiphoid, left epigastric, right epigastric, left renal area, right renal area, pelvic cavity) akasarudzwa kuti aonekwe nekukurumidza kwekukuvara kunouraya.

1. Kuonekwa kweacute blunt force kana kukuvara kwemhepo muhunde uye mvura isina mudumbu mudumbu: FAST kuongororwa inoshandiswa pakuona kwekutanga kubuda kwepleural kubuda, uye kuona nzvimbo yekubuda ropa uye huwandu (pericardial effusion, pleural effusion, abdominal effusion, pneumothorax, nezvimwewo).
2.Kukuvara kwakajairika: chiropa, spleen, pancreas kukuvara
3. Zvakajairwa zvisiri zvinoshungurudza: acute appendicitis, acute cholecystitis, gallstones uye zvichingodaro.
4. Kazhinji gynecology: ectopic pregnancy, placenta previa, kushungurudzika kwepamuviri, nezvimwewo
5. Kushungurudzika kwevana
6. Unexplained hypotension uye zvichingodaro zvinoda FASA miedzo

Akuiswa kweinotakurika ultrasound mukatizvemwoyo

Kukurumidza uye kunoshanda kuongororwa kwehukuru hwese uye basa remoyo, ukuru hwemakamuri ega emoyo, mamiriro emyocardial, kuvapo kana kusavapo kwekudzokazve, basa revhavha, chikamu che ejection, vhoriyamu yehuwandu hwehuwandu hwekuongorora, yemoyo pombi yekuongorora basa, nekukurumidza. kuona zvikonzero zve hypotension, kuruboshwe uye kurudyi ventricular systolic / diastolic basa, kutungamira kurapa kwemvura, kudzoreredzwa kwevhoriyamu, kutungamirira cardiopulmonary monitoring, Varwere veTrauma havana kuputika kwemoyo uye kukurumidza kurapwa kwepervical effusion uye ropa, nezvimwewo.

1. Pericardial effusion: Kukurumidza kuzivikanwa kwepericardial effusion, pericardial tamponade, ultrasound-inotungamirirwa pericardial puncture
2. Massive pulmonary embolism: Echocardiography inogona kubatsira kubvisa mamiriro ane zviratidzo zvakafanana ne pulmonary embolism, zvakadai se cardiac tamponade, pneumothorax, uye myocardial infarction.
3. Kuruboshwe ventricular function assessment: Left ventricular systolic function yakaongororwa nekukurumidza scan yekuruboshwe huru axis, kuruboshwe ruduku axis, apical four-chamber heart, uye left ventricular ejection fraction.
4. Aortic dissection: Echocardiography inogona kuona nzvimbo ye dissection, uyewo nzvimbo yekubatanidzwa.
5. Myocardial ischemia: Echocardiography inogona kushandiswa kuongorora mwoyo kune abnormal wall movement.
6. Chirwere chemoyo cheValvular: Echocardiography inogona kuona maungira evharuvhu asina kujairika uye shanduko mukuyerera kweropa.

Kushandiswa kweinotakurika ultrasound mumapapu

1. Yakashandiswa kuongorora kuomarara kwepneumonia yepakati-yepakati, tunhu tudiki twepulmonary hydrosis hunooneka mumapapu.
2. Mapapu ese ari maviri anoparadzira mutsara wekubatanidza B, unoratidza chiratidzo che "white lung", kubatanidzwa kwakanyanya kwemapapu.
3. Tungamira marongero emhepo inofefetera uye tarisa mamiriro ekuwedzera kwemapapu
4. Kuongororwa kwepneumothorax: stratospheric sign, lung point uye zvimwe zviratidzo zvinoratidza kuvepo kwepneumothorax.

Kushandiswa kweinotakurika ultrasound mune tsandanyama tendon

1. Ultrasound inogona kuongorora kana tendon yakabvaruka uye chiyero chekubvarura
2. Kune varwere vane marwadzo uye kuzvimba kwemaoko nemakumbo, ultrasound inogona kukurumidza uye yakavimbika kuongorora tenosynovitis, iyo inobatsira kuvandudza hutano hwekutarisira uye kusarudza kurapa kwakakodzera.
3. Ongorora kubatanidzwa kwekubatana muchirwere chearthritis chisingaperi
4. Kunyatsotungamira tendon uye bursae aspiration uye soft tissue injection

Kushandiswa kweinotakurika ultrasound mukutungamira kwekiriniki

1. Ultrasound-inotungamirirwa nechepakati mutsinga catheterization (mukati jugular vein, subclavian vein, femoral vein)
2. Ultrasound inotungamirirwa PICC puncture
3. Ultrasound-inotungamirirwa catheterization yeropa rinoputika
4. Ultrasound inotungamirirwa thoracic puncture drainage, ultrasound inotungamirirwa nedumbu puncture drainage.
5. Ultrasound-inotungamirirwa pericardial effusion puncture
6. Ultrasound-inotungamirirwa percutaneous hepatogallbladder puncture

Zvinogona kuoneka kuti inotakurika ruvara Doppler ultrasound diagnostic chiridzwa chine huwandu hwakanyanya hwekushandisa munjodzi dzakakomba, zvichipa hwaro hwakavimbika hwekuwedzera kuongororwa kwekiriniki uye kurapwa, uye nekuona kuti varwere vakakomba vanogona kupedzisa mubhedha wemoyo ultrasound kuongororwa pasina kusiya wadhi yekuchengeta, kuvandudza zvakanyanya kuongororwa uye kurapwa kwevarwere vakakomba.