肝病常规体检之外:POCUS。

J A Velarde-Ruiz Velasco, D K Tapia Calderón, E Llop Herrera, G Castro Narro, E S García Jiménez, E Cerda Reyes, F Higuera de la Tijera, A D Cano Contreras, R Moreno Alcántar, R M Chávez Ramírez, J L Calleja Panero
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引用次数: 0

摘要

护理点超声(POCUS)是指通过患者床边的袖珍超声设备使用超声成像,进行诊断或指导手术,并立即回答临床问题。它的目标是扩大体检范围,而不是取代传统的超声波研究。POCUS已经发展成为体检的补充,并被包括肝病在内的不同医学专业所采用。对POCUS在肝病学中应用的证据进行了叙述性综合,描述了其在肝硬化、代谢功能障碍相关脂肪变性肝病(MASLD)、失代偿性肝硬化和门脉高压诊断中的作用。该综述还包括最近在肝硬化危重患者、其他肝病患者的血液动力学评估以及超声指导手术中的应用。POCUS可以构成胃肠病学家和肝病学家日常临床实践的一部分,简化对患者的初步评估并优化临床管理。它的可访问性、易用性和低不良事件发生率使POCUS成为在适当的临床环境中受过适当培训的医生的有用工具。这篇综述的目的是描述POCUS在胃肠病学家和肝病学家的日常临床实践中有用的现有证据。
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Beyond conventional physical examination in hepatology: POCUS.

Point-of-care ultrasound (POCUS) refers to the use of ultrasound imaging through pocket-sized sonographic devices at the patient's bedside, to make a diagnosis or direct a procedure and immediately answer a clinical question. Its goal is to broaden the physical examination, not to replace conventional ultrasound studies. POCUS has evolved as a complement to physical examination and has been adopted by different medical specialties, including hepatology. A narrative synthesis of the evidence on the applications of POCUS in hepatology was carried out, describing its usefulness in the diagnosis of cirrhosis of the liver, metabolic dysfunction-associated steatotic liver disease (MASLD), decompensated cirrhosis, and portal hypertension. The review also encompasses more recent applications in the hemodynamic evaluation of the critically ill patient with cirrhosis of the liver, patients with other liver diseases, as well as in the ultrasound guidance of procedures. POCUS could make up part of the daily clinical practice of gastroenterologists and hepatologists, simplifying the initial evaluation of patients and optimizing clinical management. Its accessibility, ease of use, and low adverse event profile make POCUS a useful tool for the properly trained physician in the adequate clinical setting. The aim of this review was to describe the available evidence on the usefulness of POCUS in the daily clinical practice of gastroenterologists and hepatologists.

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