CAJ | 학술논문

目的超声心动图对重症监护室(intensive care unit,ICU)患者的管理有着重要的作用,研究分析由具备基本心脏超声检查能力的ICU医师完成的超声检查对ICU患者管理的意义.方法采用回顾性临床观察研究的方法,纳入并记录2009年8月～2010年5月本院ICU中行经胸超声心动图(trans-thoracic echocardiogram,TTE)或经食管超声心动图(trans-esophageal echocardiogram,TEE)超声心动图检查的患者的基本信息,所患疾病,超声检查指征,阳性发现及对原有诊疗的改变.结果共82例ICU患者行超声检查142次,其中包括各种原因引起的感染性休克43例,失血性休克8例,及急性呼吸窘迫综合征31例,其中TTE86次,TEE56次.超声改变了54例(66％)患者的治疗策略,其中包括调整血管活性药物及容量治疗策略,及时外科干预及有创治疗或检查等.结论超声心动图对指导ICU患者的监测及治疗有着重要的意义,由ICU医师实施超声检查是可行的.超声在ICU中最主要的应用于评价血流动力学指标,心室功能及容量情况,同时其也能对一些ICU中常见严重并发症做出及时正确的诊断.
목적 초성심동도대중증감호실(intensive care unit,ICU)환자적관리유착중요적작용,연구분석유구비기본심장초성검사능력적ICU의사완성적초성검사대ICU환자관리적의의.방법 채용회고성림상관찰연구적방법,납입병기록2009년8월～2010년5월본원ICU중행경흉초성심동도(trans-thoracic echocardiogram,TTE)혹경식관초성심동도(trans-esophageal echocardiogram,TEE)초성심동도검사적환자적기본신식,소환질병,초성검사지정,양성발현급대원유진료적개변.결과 공82례ICU환자행초성검사142차,기중포괄각충원인인기적감염성휴극43례,실혈성휴극8례,급급성호흡군박종합정31례,기중TTE86차,TEE56차.초성개변료54례(66％)환자적치료책략,기중포괄조정혈관활성약물급용량치료책략,급시외과간예급유창치료혹검사등.결론 초성심동도대지도ICU환자적감측급치료유착중요적의의,유ICU의사실시초성검사시가행적.초성재ICU중최주요적응용우평개혈류동역학지표,심실공능급용량정황,동시기야능대일사ICU중상견엄중병발증주출급시정학적진단.
Objective Echocardiography has been shown to play an important role in management of critically ill patient.We then present a study of the impact of echocardiography done by well trained internist on management of patients in intensive care unit(ICU).Methods In this retrospective chnical study,both trans-thoracic(TTE)and trans-esophageal echocardiogram(TEE),performed on our ICU from August 2009 to May 2010.We recorded patient characteristics,indication for the echocardiogram,complication of TEE and any change in management that occurred as a result of the exam.Results 142 echocardiograms were performed in 82 patients,including 86 TTEs and 56 TEEs.Indications for echo include hemodynamic instabihty(76％),suspected cardiac effusion(7％),pulmonary embolism(5％),infectious endocarditis(3％),refractory hypoxia(2％)and atrial fibrillation (5％).Management was changed directly as a result of echocardiogram exam in 66％ of studies.Changes included change in inotrope or drug therapy,fluid administration and surgical consultation.Conclusion Echocardiography may have a significant impact on the management of patients in the general ICU.