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肺部超声
$69.07
肺部超声的正确扫查方法是什么?如何判断典型的肺滑动、海岸征、肺搏动、A线、B线?如何灵活使用肺部超声诊断各种肺部急危重症?日系经典带你打破超声禁区掌握系统规范肺部超声实操技巧
全书分基础篇和高级篇两部分,共22章,基础篇介绍了肺部超声的探头选择、扫查方法、仪器调节、成像原理、图像显示方法,详细讲解了肺滑动、海岸征、肺搏动、A线、B线以及如何探查胸腔积液、胸膜综合征等;高级篇通过实例介绍了气胸、肺水肿、肺炎、间质性肺炎、血胸、肺栓塞、胸膜侧肺部疾病与胸膜疾病的超声诊断要点、BLUS和FALLS方案、横膈功能的评价、单肺通气、食管和气管插管、皮下气肿等临床陷阱和临床常见问题。
译者简介朱强---主任医师,教授 首都医科大学附属北京同仁医院黄慧莲---主治医师 首都医科大学附属北京同仁医院
基础篇01 探头的选择与扫查方法 •21.1 探头的种类与特点•• 21.2 手持探头的方法与基本操作 •• 31.3 需要掌握的仪器设置调节 ••402 图像显示方法 ••72.1 图像方位至关重要 ••• 72.2 原则:显示方法应与CT相同 ••82.3 探头与图像的关系 ••803 肺部超声成像原理 •113.1 超声与X线的不同 ••113.2 声波反射率:图像中的白色、黑色表现 •••123.3 肺部超声的基本表现 •133.4 多重反射(A 线) •143.5 肝的镜面效应 ••1504 正常:肺滑动(B 型超声) • 164.1 移动的胸膜线——肺滑动 •164.2 观察肺滑动的探头选择 ••174.3 辅助征象:使用彩色多普勒显示能量肺滑动 •••1805 正常:海岸征 ••205.1 海岸征的定义 ••205.2 海岸征的作用 ••215.3 不同探头下的海岸征 ••215.4 显示海岸征的“陷阱” •2206 正常:肺搏动(B 型超声) •••266.1 肺搏动是心脏搏动传导至胸膜的表现 266.2 适合探查肺搏动的探头 •••276.3 若能确认肺搏动,就能排除气胸 ••2807 正常或异常:A 线(B 型及M 型超声) 297.1 A 线出现的病理状态•• 297.2 A 线产生机制 •3108 B 线••338.1 B 线是细小的多重反射伪像 ••• 338.2 B 线是胸膜发出的激光影 ••348.3 正常或异常的判断方法 ••358.4 适合显示B 线的探头 •• 3709 胸腔积液(窗帘征、脊柱征) ••389.1 探查胸腔积液,超声检查效果好 •389.2 适合检查胸腔积液的探头 ••389.3 获取图像的技巧 ••389.4 超声能否判断胸腔积液的性质 ••4210 异常:后外侧肺泡和(或)胸膜综合征 •4310.1 PLAPS 的含义 ••4310.2 闪闪发亮的肺 •••4310.3 探查部位 •4310.4 探头的选择 •••4510.5 具体的运用 ••••••• 47高级篇11 气胸:诊断流程 ••••••• 5011.1 诊断气胸 ••••5011.2 肺点 •••••5111.3 流程图 •••5212 弥漫性A 线,无PLAPS •••5413 肺水肿 ••5814 肺炎 ••••6215 间质性肺炎 •••6715.1 肺部超声中的间质综合征 ••• 6915.2 能否从间质综合征中诊断出间质性肺炎 ••• 6916 血胸(创伤病例) •••7116.1 血胸 •••7116.2 肋骨骨折 ••7316.3 肺挫伤 •7317 急性肺血栓栓塞症 •••• 7518 BLUE 方案和FALLS 方案 8018.1 BLUE 方案 •••8018.2 FALLS 方案 ••8319 胸膜侧肺部疾病与胸膜疾病 •8619.1 掌握胸壁的解剖结构 ••8619.2 胸膜侧肺部疾病与胸膜疾病的B 型超声诊断 ••• 8719.3 能量多普勒、B-fl ow color 的血流显示 ••8719.4 关于超声造影检查 ••9220 陷阱:皮下气肿、横膈损伤、胃 ••••9521 横膈功能的评价 •••9921.1 利用超声观察横膈 •9921.2 2 种检查方法 •••10022 单肺通气、食管插管、气管插管 •••10322.1 单肺通气 ••10322.2 食管插管 •10322.3 气管插管 • 104
译者前言由于肺内气体的影响,肺部的超声检查长久以来被认为是超声的禁区。然而,随着超声医师对超声技术的认识不断提高以及对肺部病理的了解逐渐深入,他们发现可以利用超声在肺部产生的伪像来诊断肺部疾病的病理状态。目前,国外已将超声较广泛地应用于肺炎、肺实变、气胸、肺挫伤、膈肌功能障碍、急性呼吸窘迫综合征等疾病的诊断检查。国内部分医院也已开始了这一领域的工作,并已有相关文献报道。这种发展不仅充实了超声医学的内容,而且将促进超声技术向精细化、纵深化方向发展。此外,肺部超声已得到呼吸重症科、急诊科、麻醉科等科室的关注。它能帮助判断患者是否可以脱离呼吸机、帮助判断休克类型,还可以指导麻醉患者的呼吸管理等诊疗过程。肺部超声极有可能成为超声医学的一门新兴的亚专业。本书从肺部超声的基础操作开始讲解,逐渐深入到临床应用,且图文并茂、文字精炼,可为广大超声科医师及上述其他相关科室的医师学习肺部超声提供良好的参考,不失为一本可读性较强的工具书。在翻译过程中,译者力求做到准确与流畅,但限于水平,难免会有错漏之处,敬请读者谅解并指正。朱 强2021 年10 月19 日
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