Ukusetyenziswa kweklinikhi ye-ultrasound engxamisekileyo
Ngophuhliso oluqhubekayo loluntu, ukuhlolwa kwe-ultrasound kuye kwaba yenye yeendlela eziyimfuneko zokuxilongwa kwezonyango.Kunyango olungxamisekileyo, uvavanyo oluphathwayo lwe-ultrasound lunoluhlu olubanzi, ukuchaneka okuphezulu, isivinini sokuhlola ngokukhawuleza, ukungabikho kwengozi kwaye akukho zichaso.Uvavanyo oluphindaphindiweyo lunokukhawuleza ukuhlola izigulane kuyo nayiphi na imeko, ukuphumelela ixesha elixabisekileyo lokuhlangula izigulane ezinomothuko onobungozi obulalayo, kwaye wenze ukunqongophala kwe-X-reyi.Ukuqinisekiswa okufanayo ngoviwo lweX-reyi;Eyona nzuzo inkulu kukuba izigulane ezingxamisekileyo ezinokujikeleza okungazinzanga okanye ekungafanelanga zishukunyiswe ziyakwazi ukuvavanywa nanini na naphi na, kwaye akukho mda wesigcawu, eyona ndlela yoviwo yokuqala yezigulane ezigula kakhulu.
1.Ukusetyenziswa kwe-ultrasound ephathekayo kwi-trauma yokuqala kunye nesisu esibuhlungu
Ugxininiso lwe-Ultrasound Assessment of Trauma (FAST) : Amanqaku amathandathu (i-subxiphoid, i-epigastric ekhohlo, i-epigastric yasekunene, indawo ye-renal ekhohlo, i-renal right area, i-pelvic cavity) ikhethwe ngokukhawuleza ukuchongwa kwesifo esibulalayo.
I-01 Ukufunyanwa kwe-acute blunt force okanye ukulimala komoya kwi-trunk kunye nolwelo olukhululekile kwisisu: Uvavanyo lwe-FAST lusetyenziselwa ukuxilongwa kwangaphambili kwe-pleural hemorrhage, kunye nokuchonga indawo yokopha kunye nobungakanani (i-pericardial effusion, i-pleural effusion, i-peritoneal effusion, i-pneumothorax njl.).
02 Ukulimala okuqhelekileyo: isibindi, i-spleen, i-pancreas ukwenzakala.
03 Okuqhelekileyo okungeyongozi: i-appendicitis ebukhali, i-cholecystitis ebukhali, i-gallstones kunye nokunye.
04 I-gynecology eqhelekileyo: ukukhulelwa kwe-ectopic, i-placenta previa, i-trauma yokukhulelwa, njl.
05 Ukwenzakala kwabantwana.
06 I-hypotension engachazwanga njalo njalo ifuna iimvavanyo ze-FASA.
2.Ukusetyenziswa kwe-ultrasound ephathekayo entliziyweni
I-Echocardiography ngumgangatho wegolide ekuxilongweni kwezifo ezininzi zentliziyo kunye ne-pericardial.
I-01 I-Pericardial effusion: Ukuchongwa ngokukhawuleza kwe-pericardial effusion, i-pericardial tamponade, i-ultrasound-guided puncture ye-pericardial.
I-02 I-Massive pulmonary embolism: I-Echocardiography inokunceda ukulawula iimeko ezineempawu ezifana ne-pulmonary embolism, ezifana ne-cardiac tamponade, i-pneumothorax, kunye ne-myocardial infarction.
I-03 Ukuhlolwa komsebenzi we-ventricular yasekhohlo: Umsebenzi we-systolic we-ventricular wasekhohlo uhlolwe ngokukhawuleza kwe-axis enkulu ekhohlo, i-axis encinci yekhohlo, intliziyo ye-apical yamagumbi amane, kunye neqhezu le-ventricular ejection fraction.
I-04 i-Aortic dissection: I-Echocardiography inokubona indawo yokutshatyalaliswa, kunye nendawo yokubandakanyeka.
05 I-Myocardial ischemia: I-Echocardiography ingasetyenziselwa ukuvavanya intliziyo malunga nokuhamba okungaqhelekanga kodonga.
06 Isifo sentliziyo seValvular: I-Echocardiography inokubona i-echoes yevalvu engaqhelekanga kunye notshintsho kwi-spectrum yokuhamba kwegazi.
3.Ukusetyenziswa kwe-ultrasound ephathekayo kwimiphunga kunye ne-diaphragm
01 Isetyenziselwa ukuvavanya ubuzaza benyumoniya yesigaba sakwangoko-esiphakathi, imiphunga emincinane ye-pulmonary hydrophilia ibonakala emiphungeni - Uphawu lomgca B.
02 Isetyenziswe kuxilongo lwezigulana ezibukhali zenyumoniya, yomibini imiphunga isasaza udibaniso lwe-B-line, ebonisa uphawu "lwemiphunga emhlophe", iimeko ezinzima zivela ukuqiniswa kwemiphunga.
03 Ukuxilongwa kwe-pleural effusion, i-ultrasound guided puncture drainage ye-pleural effusion.
04 Ukuxilongwa kwe-pneumothorax: uphawu lwe-stratospheric, indawo yemiphunga kunye nezinye iimpawu zibonisa ubukho obunokwenzeka be-pneumothorax.
05 Khokela ukusetwa kwesixhobo sokungenisa umoya kwaye ujonge imeko yokwandiswa kwakhona kwemiphunga.
06 Ukusetyenziswa kwe-diaphragmatic ultrasound, ekhokelwa ngaphandle kwe-line, ukwahlula ukuhluleka kokuphefumula okuphakathi kunye ne-peripheral.
4.Ukusetyenziswa kwe-ultrasound ephathekayo kwi-tendon ye-muscle
I-01 I-Ultrasound inokuvavanya ukuba i-tendon ikrazukile kunye nobungakanani bokukrazula.
02 Kwizigulane ezinentlungu kunye nokuvuvukala kwezandla kunye neenyawo, i-ultrasound inokukhawuleza kwaye iqiniseke ngokuxilonga i-tenosynovitis, enceda ukuphucula umgangatho wokunyamekela kwaye ukhethe unyango olufanelekileyo.
03 Vavanya ukubandakanyeka ngokubambisana kwi-arthritis engapheliyo.
04 Khokela ngokuchanekileyo i-tendon kunye ne-bursae aspiration kunye nenaliti yethishu ethambileyo.
5.Ukusetyenziswa kwe-ultrasound ephathekayo kwisikhokelo seklinikhi
01 I-Vascular puncture: ukubonwa kwe-catheterization ye-vein enzulu, i-arterial puncture, njl.
02 Isikhokelo sokubekwa kwemaski yelaryngeal.
03 Intubation yetrachea ekhokelwayo.
04 Ukuhlatywa ngokudibeneyo, ukuvaleka kwemithambo-luvo, njl.
05 Isikhokelo se-pericardial cavity, i-thoracic cavity, i-abdominal cavity, njl.
06 I-cyst, isikhokelo sokugqobhoza ithumba, njl.
Ingabonwa ukuba uluhlu lwesicelo sombala ophathwayo wesixhobo sokuxilonga i-Doppler ultrasound sibanzi kakhulu, kwaye uluhlu lokuhlola lubanzi, luchanekile oluphezulu, ukuhlolwa okukhawulezayo, ukungabikho kwengozi, akukho contraindications, ukuhlolwa okuphindaphindiweyo;Uphononongo oluphathekayo lweDoppler lombala lunezi nzuzo zibalulekileyo zilandelayo:
Incinci kwaye iphathekayo, inokuthwalwa ngokuthe ngqo ngesandla, ehambelana nabasebenzi bezonyango ukuba baphathe ngokukhawuleza i-ultrasound kwindawo yonyango.
Isantya sokuhlola sikhawuleza, sinokuphinda siphindwe, akukho ntlupheko, akukho contraindications.
Ukulungelelanisa kwiindawo ezahlukeneyo zokusebenza, kubandakanywa nombhede, i-ICU, ungxamiseko, ukutyelela kwintsimi, njl.
Umgangatho womfanekiso ogqwesileyo kunye nenkxaso yesisu, i-superficial kunye ne-cardiac probes kunye noluhlu olubanzi lwezicelo ukuhlangabezana neemfuno ezahlukeneyo zeklinikhi.
Unyango lokungenelela kwe-Ultrasound, iliso le-ultrasound elithwelwe ngugqirha.
Isixhobo esiphathwayo sokuxilongwa kwe-Doppler sombala sibonelela ngesiseko esithembekileyo sokuxilongwa ngakumbi kweklinikhi kunye nonyango, kwaye uyaqonda ukuba izigulane ezibaluleke kakhulu zinokugqiba uviwo lwe-ultrasound lwentliziyo ngaphandle kokushiya i-ICU, ephucula kakhulu ukuxilongwa kunye nonyango lwezigulane ezinzulu.
Ixesha lokuposa: Nov-13-2023
