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題 名 | 經食道心臟超音波(TEE)在急重症照護的應用=The Role of Transesophageal Echocardiography in Critically Ill Patients |
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作 者 | 蔡勝國; | 書刊名 | 中華民國重症醫學雜誌 |
卷 期 | 4:4 2002.10[民91.10] |
頁 次 | 頁224-231 |
分類號 | 415.3024 |
關鍵詞 | 經食道心臟超音波; 心臟影像; 急症照護; Transesophageal echocardiography; Cardiac imaging; Critical care emergencies; |
語 文 | 中文(Chinese) |
中文摘要 | 重症病人心臟功能的評估,受限於病人病情的急遽變化及無法運送到檢查室的限制,必須及時,就地在床邊,以導管或影像監測提供方便、快速且準確的資料,來決定正確的處置,經食道心臟超音波已被證實是一安全且非常多功能的心臟功能診斷工具。 根據統計指出,在加護中心病患如有"無法解釋的低血壓",經食道心臟超音波診斷後有約20%的病人可能是術後出血引起心包膜填塞,壓迫心臟血流或急性二尖瓣回流引起肺水腫。對於"可恢復性心臟暫停",在心肺急救時,可快速診斷心肺血栓、心包膜填塞或血量不足(hypovolemia)等原因而加以處理,此外如胸部挫傷,人工瓣膜放置後引起的問題(血栓或脫落),乳頭肌折損或功能不全,心包膜填塞、血液動力不穩定的病患,或須要急診手術或再手術的病患,提供了快速而且有價值的資料。 本文就實際臨床重症的案例,提出代表性的影像及治療的結果,來探討經食道心臟超音波的應用價值。 |
英文摘要 | Acute ill patients during intensive care require urgent and expeditions evaluation in order to institute the proper medical is surgical management. However, clinical care in such patent's at intensive care unit only with intravenous infusion, hemodynamic monitors, mechanical ventialation but les lifesaving diagnostic tool to access cardiopulmonary instability. Echocardiography can provide structural, functional and hemodynamic data in the critical ill patients. Unfortunately, the transthorasic approach was limited acoustic window in trauma or postoperative period because drainage tubes, bandages mechanical ventilator. In contrast, transesophageal echocardioghy (TEE) can provide an excellent acoustic window to overcome such problems in critical ill patients TEE is not only useful in the man agreement of cardiac patient after surgery to evaluate the adequate postoperative repair, hemodynamic but also to identify the reversible cause of cardiac arrest such as cardiac tamponade, hypovolemic massive pulmonary embolism or tension pneumothorax. Therefore the decision-making can made early and save the patients some important aspects of TEE use in acute ill patients were presented and discussed. |
本系統中英文摘要資訊取自各篇刊載內容。