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目的:探讨床边超声心动图检查在首次诊断心血管急危重症疾病中的应用价值及操作体会。方法:回顾性分析我院2010-01-2010-12期间行急诊床边超声心动图检查共271例患者的资料。结果:床边超声心动图检查的阳性率为44.3%,其中有节段性室壁运动异常的急性冠状动脉综合征94例(包括室壁瘤破裂1例),瓣膜性疾病6例,心包积液5例,主动脉夹层3例,感染性心内膜炎赘生物2例,先天性心脏病3例,心房占位性病变4例,其他3例。因床边超声心动图检查首次确诊疾病,修正临床治疗,甚至挽救患者生命的有20例。结论:对症状不典型、初诊为急性冠状动脉综合征的主动脉夹层,及时进行床边超声心动图检查可起到鉴别诊断、改变治疗方案的作用;对表现为胸闷或气促的心包大量积液患者可明确诊断,指导心包穿刺引流;对高度怀疑的急性肺栓塞,床边超声心动图检查可现场动态观察临床抢救是否有效。
Objective: To explore the application value and operation experience of bedside echocardiography in the first diagnosis of cardiovascular emergencies. Methods: A retrospective analysis of our hospital from January 2010 to December 2010 during emergency bedside echocardiography a total of 271 cases of patients. Results: The positive rate of bedside echocardiography was 44.3%. There were 94 cases of acute coronary syndrome with segmental wall motion abnormalities (including ruptured aneurysm in 1 case), valvular disease in 6 cases, pericardial 5 cases of fluid, 3 cases of aortic dissection, 2 cases of infective endocarditis neoplasms, congenital heart disease in 3 cases, atrial space-occupying lesions in 4 cases, the other 3 cases. First confirmed by bedside echocardiography disease diagnosis, revision of clinical treatment, and even save the lives of patients with 20 cases. Conclusion: The symptoms of atypia, newly diagnosed acute coronary syndrome in the aortic dissection, timely bedside echocardiography can play a differential diagnosis and change the role of treatment programs; manifested as chest tightness or shortness of breath pericardial mass Liquid patients can confirm the diagnosis, guiding pericardial drainage; for highly suspected acute pulmonary embolism, bedside echocardiography can dynamically observe the clinical rescue effective.