摘要
血管外肺水(EVLW)是心力衰竭患者管理及预后评估的关键指标,但目前客观衡量这一指标仍较困难。一般认为由于高阻抗的空气屏障,肺部成为超声成像的禁区。然而在肺部淤血的情况下,由于水和空气同时存在,形成了一个特殊的回声现象——B线。肺部超声显示的B线是出现在胸膜强回声下的一个"彗星"样信号,其随呼吸往复运动。B线的数量和范围可以作为评估EVLW的半定量指标(≤5条B线为无肺水肿,30条B线为严重肺水肿)。本文对EVLW的超声诊断原理、价值、局限性及应用前景进行了总结。
Extravascular lung water(EVLW)is a key variable in heart failure management and prognosis evaluation,but its objective assessment remains elusive.Lung imaging has been traditionally considered off-limits for ultrasound techniques due to the acoustic barrier of high-impedance air wall.In pulmonary congestion,however,the presence of both air and water creates a peculiar echo fingerprint--B-lines.Lung ultrasound shows B-lines,comet-like signals arising from a hyperechoic pleural line with a to-and-fro movement synchronized with respiration.The number and spatial extent of B-lines on the antero-lateral chest allows a semi-quantitative estimation of EVLW〔from absent,(≤5 B-lines),to severe pulmonary edema(30 B-lines)〕.In this paper,we summarized the principle,value,limitation and application prospect of ultrasonography in the diagnosis of EVLW.
作者
张冰
ZHANG Bing(Emergency Medicine Department,Affiliated Hospital of Hebei University,Baoding 071000,China)
出处
《中国全科医学》
CAS
北大核心
2018年第12期1485-1488,共4页
Chinese General Practice
关键词
血管外肺水
超声检查
B线
Extravascular lung water
Ultrasonography
B-lines
