Ukusetyenziswa kwe-ultrasound ephathekayo kwimeko engxamisekileyo

Ukusetyenziswa kwe-ultrasound ephathekayo kwimeko 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.

Isimo sokusetyenziswa kwe-ultrasound ecaleni kwebhedi ekhaya nakwamanye amazwe

1. Kukho uqeqesho olubanzi ngakumbi nangakumbi lwe-ultrasound kwihlabathi.Okwangoku, inkqubo yoqeqesho olusisiseko kunye nengqiqo yenziwe, kwaye i-World Intensive Ultrasound Alliance (WINFOCUS) isungulwe.
2. I-American College of Emergency Physicians ifuna ukuba oogqirha bexesha likaxakeka kufuneka balawule iteknoloji ye-ultrasound engxamisekileyo, kwaye i-95% yamaziko e-trauma ye-level 1 e-United States (190) yenza i-ultrasound engxamisekileyo.
3. Oogqirha bexesha likaxakeka eYurophu naseJapan baye basebenzisa ngokubanzi i-ultrasound ukunceda izigulana ekuxilongeni nasekunyangweni
4. I-China yaqala emva kwexesha, kodwa inkqubela ikhawuleza.

Ukusetyenziswa kwe-ultrasound ephathekayo kwi-trauma yoncedo lokuqala kunye nesisu esibuhlungu

01 Ukuhlolwa kokuqala
Ukuhlolwa kwendlela yomoya ebeka ubomi esichengeni, ukuphefumla kunye nokujikeleza.- Uncedo lokuqala, likaxakeka

02 Uhlolo lwesibini
Ukuchonga ukulimala okucacileyo kuwo onke amalungu omzimba - kaxakeka, i-ICU, iwadi

03 Ukutshekisha kathathu
Ukuhlolwa okucwangcisiweyo okubanzi ukuphepha ukulahlekelwa yintlungu -ICU, iwadi

Gxininisa kuVavanyo lwe-Ultrasound ye-Trauma (FAST) :Amanqaku amathandathu (i-subxiphoid, i-epigastric ekhohlo, i-epigastric yasekunene, indawo ye-renal yasekhohlo, indawo ye-renal yasekunene, i-pelvic cavity) yakhethwa ukuchongwa ngokukhawuleza kwesifo esibulalayo.

1. Ukufumanisa amandla abukhali okanye ukulimala komoya kwi-trunk kunye nolwelo olukhululekile kwisisu: Uviwo lwe-FAST lusetyenziselwa ukufumanisa kwangaphambili ukopha kwe-pleural, kunye nokumisela indawo yokopha kunye nenani (i-pericardial effusion, i-pleural effusion, i-effusion yesisu; pneumothorax, njl.).
2. Ukulimala okuqhelekileyo: isibindi, i-spleen, i-pancreas ukulimala
3. eziqhelekileyo non-traumatic: appendicitis acute, cholecystitis acute, gallstones njalo njalo.
4. I-gynecology eqhelekileyo: ukukhulelwa kwe-ectopic, i-placenta previa, i-trauma yokukhulelwa, njl
5. Ukwenzakala kwabantwana
6. I-hypotension engachazwanga njalo njalo ifuna iimvavanyo ze-FASA

Aukufakwa kwe-ultrasound ephathekayo ngaphakathisentliziyo

Uvavanyo olukhawulezayo nolusebenzayo lobungakanani obupheleleyo kunye nomsebenzi wentliziyo, ubukhulu bamagumbi entliziyo, imeko ye-myocardial, ubukho okanye ukungabikho kokubuyela, umsebenzi wevalvu, iqhekeza le-ejection, uvavanyo lwesimo segazi, uvavanyo lomsebenzi wempompo yentliziyo, ngokukhawuleza. ukufumanisa izizathu ze-hypotension, i-ventricular ye-systolic / i-diastolic ye-ventricular yasekhohlo nasekunene, unyango olukhokelayo lwe-fluid, ukuvuselela umthamo, ukukhokela i-cardiopulmonary monitoring, izigulane ze-Trauma azikho ukuphulwa kwentliziyo kunye nokunyangwa ngokukhawuleza kwe-pericardial effusion kunye negazi, njl.

1. I-Pericardial effusion: Ukuchongwa ngokukhawuleza kwe-pericardial effusion, i-pericardial tamponade, i-ultrasound-guided puncture ye-pericardial
2. I-Massive pulmonary embolism: I-Echocardiography inokunceda ukulawula iimeko ezineempawu ezifana ne-pulmonary embolism, ezifana ne-cardiac tamponade, i-pneumothorax, kunye ne-myocardial infarction.
3. Ukuhlolwa komsebenzi we-ventricular yasekhohlo: Umsebenzi we-systolic we-ventricular wasekhohlo uhlolwe ngokukhawuleza kwe-axis enkulu yasekhohlo, i-axis encinci yekhohlo, intliziyo ye-apical yamagumbi amane, kunye neqhezu le-ejection ye-ventricular ekhohlo.
4. I-Aortic dissection: I-Echocardiography inokubona indawo yokutshatyalaliswa, kunye nendawo yokubandakanyeka
5. I-Myocardial ischemia: I-Echocardiography ingasetyenziselwa ukuvavanya intliziyo malunga nokuhamba okungaqhelekanga kodonga.
6. Isifo sentliziyo yeValvular: I-Echocardiography inokubona i-echoes yevalvu engaqhelekanga kunye notshintsho kwi-spectrum yokuhamba kwegazi.

Ukusetyenziswa kwe-ultrasound ephathekayo kwimiphunga

1. Isetyenziselwa ukuvavanya ubuzaza benyumoniya yesigaba sakwangoko-esaphakathi, iiflaks ezincinci zepulmonary hydrosis zivela emiphungeni.
2. Yomibini imiphunga isasaza umgca B wokudityaniswa, obonisa uphawu "lwemiphunga emhlophe", ukuqiniswa kwemiphunga ngamandla.
3. Khokela ukusetwa kwesixhobo sokungenisa umoya kwaye ujonge imeko yokwandiswa kwakhona kwemiphunga
4. Ukuxilongwa kwe-pneumothorax: uphawu lwe-stratospheric, indawo yemiphunga kunye nezinye iimpawu zibonisa ubukho obunokwenzeka be-pneumothorax.

Ukusetyenziswa kwe-ultrasound ephathekayo kwi-tendon ye-muscle

1. I-Ultrasound inokuvavanya ukuba i-tendon ikrazukile kunye nobungakanani bokukrazula
2. Kwizigulane ezinentlungu kunye nokuvuvukala kwezandla kunye neenyawo, i-ultrasound inokukhawuleza kwaye ihlolisise ngokunyanisekileyo i-tenosynovitis, enceda ukuphucula umgangatho wokunyamekela kwaye ukhethe unyango olufanelekileyo.
3. Ukuvavanya ukubandakanyeka ngokubambisana kwi-arthritis engapheliyo
4. Isikhokelo esichanekileyo se-tendon kunye ne-bursae aspiration kunye nenaliti ye-soft tissue

Ukusetyenziswa kwe-ultrasound ephathekayo kwisikhokelo seklinikhi

1. I-Ultrasound-guided central vein catheterization (i-jugular vein yangaphakathi, i-subclavian vein, i-femoral vein)
2. I-Ultrasound ekhokelwa yi-PICC puncture
3. I-Ultrasound-guided catheterization ye-artery invasive
4. I-Ultrasound ekhokelwa yi-thoracic puncture drainage, i-ultrasound ekhokelwa yi-abdominal puncture drainage
5. I-Ultrasound-guided pericardial effusion puncture
6. I-Ultrasound-guided percutaneous hepatogallbladder puncture

Ingabonwa ukuba umbala ophathwayo wesixhobo sokuxilonga i-Doppler ultrasound inoluhlu olubanzi kakhulu lwezicelo kwiimeko ezingxamisekileyo, ezibonelela ngesiseko esithembekileyo sokuxilongwa ngakumbi kweklinikhi kunye nonyango, kunye nokuqonda ukuba abaguli ababalulekileyo banokulugqiba uhlolo lwe-ultrasound yentliziyo ecaleni kwebhedi ngaphandle kokushiya ugqirha. iwadi yokhathalelo, iphucula kakhulu uxilongo kunye nenqanaba lonyango lwezigulane ezinobuzaza.