重症肺部超声参考幻灯片

肺部超声的临床应用ICU肺部超声基础ppt演示课件2ICU肺部超声基础ppt演示课件▣背景-▣原理-▣肺部超声基础-▣正常肺部超声图像和异常肺部超声图像-▣临床常见疾病肺部超声图像表现-▣呼困难鉴别-3由于肺泡内充满气体，超声波遇到-气体时会发生完全反射，所以长期以-来对肺部疾病的超声诊断被认为是超-声检查“禁区”-4▣受损的肺泡和间质的充气、含水量的改变所产生-的超声影像及伪影，反而使其成为可能-口近年来，-越来越多的研证实，超声对多种肺部-疾病有诊断价值，尤其是重症超声的肺部检查-口例如：肺水肿、气胸、肺炎、肺栓塞、胸水Review Article-Lung ultrasound in critically ill patints:-a new diagnostic tool-Ultrassom pulmonar em pacintes criticos:uma nova ferramenta diagnostica-肺部超声在肺部-Felippe Leopoldo Dexheimer Neto,Paulo de Tarso Rothalcin,-出性病变的鉴别诊断方-Cassiano Teixeira,Flavia Gabe Beltr mi-Abstract-面有较大的应用价值，-The evaluation of critically i l patients using lung ultrasound,even if performed by nonspecialists,has recently-garnered greater interestBecause lung ultrasound is based on the fact that evey acute illness reduces lung-对于新生儿、儿童多种-aeration,it c n provide information that complements the physical eamination and clinical impression,the main-advantageeing that it is a bedside tool.The objective of thiseview was to evaluate the clinical applications-of lug ultrasound by searching the PubMed and the BraziliaVirtual Library of Health databases.We used the-follwing search terms in Portuguese and English:ultrasoun;lung;and critical care.In addition to the most-肺部疾病的断具有很-relevant articles,we also reviewed specialized t xtbooks.The data show that lung ultrasound is usefuln the-differential diagnosis of pulmonary infiltrateshaving good accuracy in identifying consolidations aninterstitial-syndrome.In addition,lung ultrasound habeen widely used in the evaluation and treatment ofleural effusions.-好的敏感性和特异性，-as well as in the identi ication of pneumothorax.This technique can also be usful in the immediate evaluation-of patients with dyspea or acute respiratory failure.Other deseribed appliations include monitoring treatment-response and incrasing the safety of invasive procedures.Although specPneumothorax Normal lung surface Interstitialsyndrome Alveolar consolidation-Pleural effusion-air-Air-fluid ratio-AlRIno nuia-AIR/nud-AlR/nuid-air/FLUID-品幽FLUID--0.98-0.95-0.2口B型和M型-B型扫描一个解剖平面并显示二维图像-M型记录朝探头方向来回运动的结构图像-▣高频线性探头7. ~10MHz→表浅的胸膜及胸膜-下病变-▣低频凸性探头2~5MHz→深部的病变和体型肥-胖者-81702054-0--0-恐-线阵式-扇形式-凸阵式-9▣对肺脏各区域进行->纵向：探头与肋骨垂直（蝙蝠征）->横向：探头沿肋间隙走形扫查，避免肋骨影，-最大化的到胸膜线->以纵向扫查最为重要和常用-oblique-scan-longitudinal-10▣仰卧位扫查分区：-以腋前线、腋后线为界将肺脏-分成前、侧、后3个区域，以乳-头平面作为上下界线，即左/右肺脏各被分为6个区，双侧共12-个区域。