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介入性超声医学:临床医师备忘录
$37.67
1972年Goldberg和Holm成功地研制出了带有中心孔的穿刺探头,首次使得在B型声像图中同时清晰地显示病灶和穿刺针尖,显著地提高了穿刺的准确性。之后因临床诊断和治疗的需要,超声引导下穿刺诊疗技术取得了长足的进步。1983年在哥本哈根召开的世界介入性超声学术会议上,正式将它确定为现代超声医学的一个分支——介入性超声医学。其主要特点是在实时超声的监视或引导下,完成各种穿刺活检、X线造影及抽吸、插管、注射药物治疗等操作。近年来,随着超声仪器设备、导向装置、穿刺针具和导管的不断改进与发展,以及操作技术的不断提高和经验的逐步积累,介入性超声医学已深入到临床各个学科领域,几乎覆盖到全身所有脏器及部位,从而成为临床医学不可或缺的重要组成部分。介入性超声医学通过超声影像实时监测或动态引导,不但穿刺准确,而且创伤小,操作过程相对安全,诊疗效果可靠。实践证明,该项技术解决了许多内、外科难以解决的问题,有些操作甚至替代了外科手段。尤其是该技术具有超声设备小型化与可移动到床边的特点,以及操作简便、无辐射、费用相对低廉和术后皮肤不留瘢痕的优势,特别适合各级医疗机构开展应用。但是鉴于超声医学显像技术对操作者主观依赖性较强的局限性,加之国内临床超声医学专业的相对独立性(绝大多数医院超声医学为独立的学科),以及现今国内执业医师管理体制的要求,临床医师几乎没有机会熟悉或掌握介入性超声医学影像理论和技术,一定程度制约了国内该技术的发展。以往针对临床医师阅读的相关介入性超声医学专著较少,不能满足临床的需要。为了使临床医师快速了解介入性超声医学的技术优势、适应证、禁忌证、术前准备、注意事项、不良反应和并发症及其防治措施,并易于携带和随时查阅,以便加强与超声医学影像科医师或相关专业技术人员的沟通和密切协作,促进介入性超声医学在临床的推广应用,怀着这样的初衷,本书应运而生。编写组结合自身多年来开展介入性超声医学的临床实践经验,并参考《临床介入性超声学》(董宝玮主编)、《中华介入超声学》(陈敏华、梁萍、王金锐主编)和《中国介入超声临床应用指南》(中国医师协会超声医师分会编著)等相关文献,特别是近年来国内外介入性超声医学发展的新技术、新知识、新理论,编著了《介入性超声医学:临床医师备忘录》一书,旨在供临床医师和相关超声专业技术人员使用。该书编写简明扼要,直叙临床常用介入性超声技术。 为节省篇幅和避免过多重复,本书没有纳入有关介入性超声医学中的具体操作技术与规程细节,以及超声内镜、术中超声或腔镜超声引导下介入和超声引导下产科胎儿介入等涉及专科领域较强的内容。如有需求者,请进一步查阅本书末尾所附的参考文献。
章.甲状腺介入性超声……………………………………1节 超声引导下甲状腺穿刺活检术 …………………2第二节 超声引导下甲状腺囊肿穿刺抽液及硬化治疗 …6第三节 超声引导下甲状腺结节热消融治疗 ……………8
第二章.乳腺介入性超声………………………………………13节 超声引导下乳腺穿刺活检术 ……………………14第二节 超声引导下乳腺肿瘤消融治疗 …………………17
第三章.浅表淋巴结介入性超声………………………………21节 超声引导下浅表淋巴结穿刺活检术 ……………22第二节 超声引导下转移性淋巴结热消融治疗 …………23
第四章.超声在心脏及大血管介入术中的应用………………25节 超声引导下房间隔缺损或卵圆孔未闭封堵治疗 …29第二节 超声引导下室间隔缺损封堵治疗 ………………30第三节 超声引导下动脉导管未闭封堵治疗 ……………31第四节 超声引导下左心耳封堵术 ……………………… 32第五节 超声在TAVR介入术中的应用及其他技术 ……34第六节 超声引导下心包积液穿刺置管引流术 …………37
第五章.肺部及胸部介入性超声………………………………41节 肺部介入性超声 …………………………………42第二节 胸部介入性超声 …………………………………47
第六章.肝、胆、胰、脾、腹腔、胃肠及腹膜后介入性超声……55节 肝脏介入性超声 …………………………………56第二节 胆囊及胆道系统介入性超声 ……………………71第三节 胰腺介入性超声 …………………………………78第四节 脾脏介入性超声 …………………………………84第五节 腹腔、胃肠及腹膜后介入性超声 ………………89
第七章.泌尿系统介入性超声…………………………………99节 超声引导下肾穿刺活检术 ……………………100第二节 超声引导下经皮肾盂造瘘术 …………………104第三节 超声引导下前列腺穿刺活检术 ………………107第四节 超声引导下肾囊肿穿刺抽液及硬化治疗 ……110第五节 超声引导下肾及肾上腺肿瘤消融治疗 ………114
第八章.妇科介入性超声……………………………………119节 超声引导下妇科疾病穿刺活检术 ……………120第二节 超声引导下妇科盆腔囊肿硬化治疗 …………121第三节 超声引导下卵巢子宫内膜异位囊肿穿刺硬化治疗 …124第四节 超声引导下盆腔积液穿刺抽吸和置管引流术 …134第五节 超声引导下子宫肌瘤消融治疗 ………………137
第九章.肌肉骨骼及浅表组织介入性超声…………………143节 超声引导下肌肉骨骼穿刺活检术 ……………144第二节 超声引导下软组织肿瘤穿刺活检术 …………146第三节 超声引导下肌肉骨骼、关节的穿刺注药治疗 …149第四节 超声引导下腘窝囊肿穿刺抽液及硬化治疗 …151第五节 超声引导下外周神经阻滞 ……………………154第六节 超声引导下肩袖钙化性肌腱炎冲洗及抽吸治疗 …156
第十章.超声在血管疾病介入治疗中的应用………………159节 超声在动脉疾病介入治疗中的应用 …………160第二节 超声在静脉疾病介入治疗中的应用 …………164第三节 超声介入治疗在其他血管疾病中的应用 ……178
第十一章.介入性超声在腹部创伤治疗中的应用…………183节 超声造影引导经皮注射治疗肝创伤 …………184第二节 超声造影引导经皮注射治疗脾创伤 …………186第三节 超声造影引导经皮注射治疗肾创伤 …………188
第十二章.放射性粒子植入的介入性超声…………………191附录一 泡沫硬化剂-聚桂醇注射液…………………………195附录二 缩略词表………………………………………………199参考文献………………………………………………………203附 图…………………………………………………………223
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