2014-重症超声的临床应用.pptx

重症超声的临床应用;重症超声的临床应用;重症超声的临床应用;;Case 1;Case 2;Discussion; 血流动力学监测 影像学检查 ;休克复苏的超声应用;The pump： Cardiac status;A：left ventricular contractility;Poor left ventricular contractility;Global left ventricular hypokinesia is very frequent in adult septic shock and could be unmasked, in some patients, by norepinephrine treatment (the overall incidence of global LV hypokinesia was 60%). ;左心收缩功能定性评价;RV enlargement: dysfunction Small changes in pressure result in large changes in ventricular volume left-to-right Ventricleis 1 : 0 .6;B：right ventricular dilation;C：Signs of tamponade;C：pericardial effusions;;Pelvic free fluid Free fluid in the rectovesicular space ;A：Fullness of the Tank;A larger IVC 2 cm that collapses50% with sniff suggests a high CVP pressure of 15 mmHg;Intubated patients, the IVC becomes larger and less compliant;Echocardiographic indices of volume responsiveness;超声对容量状态的评估 -低血容量乳头肌亲吻征;包括9个相关研究，其中6个研究应用了超声技术;Focused Assessment of Sonography for Trauma (FAST ) Hemoperitoneum Hemothorax Ruptured ectopic pregnancy;;Pelvic free fluid Free fluid in the rectovesicular space ;;Pneumothorax;正常肺超声;肺水肿时超声影像;肺实变的超声特征;胸腔积液的超声影像;肺部病变超声-Interstitial syndrome;Pleural effusion and alveolar consolidation; typical example of PLAPS (Posterolateral alveolar and/or pleural syndrome );气胸时超声影像;气胸超声确诊：肺点(Lung Point);气胸诊断流程;41;;;常规体表定位法;;血管解剖变异;置管并发症;方 式;确定静脉的方法;超声横断面引导法和纵段面引导法 ;;;超声引导下纵断面穿刺法（平面内）;超声引导下横断面穿刺法（平面外）;;;气管插管位置确认;气管插管异位;腹部超声;视神经的超声影像;B: Obstruction of the Pipes;Abdominal Aortic Aneurysm AAA rupture: back pain, hypotension, pulsatile abdominal mass An AAA : vessel diameter exceeds 3cm Sensitivity: 94%-98% Specificity: 100% Fluid in retroperitoneal space ;64;Others;重症超声 重症医学工作者的得力助手 开辟新的领域 重症医学走得更远;