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超声引导下心包穿刺术在未来战场上的应用前景
侯攀1,刘洋2,李鹏昊2,张必利1,李攀1,赵仙先1*
0
(1. 海军军医大学(第二军医大学)长海医院心血管内科, 上海 200433;
2. 海军军医大学(第二军医大学)基础医学院学员一大队, 上海 200433
*通信作者)
摘要:
战时心包填塞常发生于心脏损伤时,伤死率极高。心包穿刺术可以在短时间内缓解心脏受压,为伤员后送赢得时间。现阶段,战场环境下一般仅采用盲穿法进行心包穿刺。近年来,超声设备日趋便携化和智能化,已经具备应用于战场的条件,超声引导下的心包穿刺术有望应用于未来战场火线救护。但是心包穿刺术的操作技术难度大、风险高且缺乏廉价有效的培训模型及系统,目前军队基层卫生人员对于这一技术的掌握远远不足。本文就国内外心包穿刺术在平时培训与战时应用的现状进行综述,并就如何构建一套完整的培训和应用系统以提高军队基层卫生人员对超声引导下心包穿刺术的掌握程度提出可行化建议。
关键词:  心包穿刺术  超声引导  战场救护  培训
DOI:10.16781/j.0258-879x.2021.03.0324
投稿时间:2020-06-07修订日期:2020-09-28
基金项目:上海市卫生和计划生育委员会优秀青年人才项目(2017YQ029).
Ultrasound-guided pericardiocentesis in the future battlefield: the prospect
HOU Pan1,LIU Yang2,LI Peng-hao2,ZHANG Bi-li1,LI Pan1,ZHAO Xian-xian1*
(1. Department of Cardiovasology, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. The First Student Team, College of Basic Medical Sciences, Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Pericardial tamponade often occurs when the heart is damaged on the battlefield, and the mortality is quite high. Pericardiocentesis can relieve the pressure on the heart in a short time, and gain time for casualty evacuation. However, at present only blind pericardiocentesis is performed in battlefield environment. In recent years, ultrasonic equipment has become increasingly more portable and intelligent, which has already gained the potential to be applied for the future battlefield, and ultrasound-guided pericardiocentesis is also expected to be applied for battlefield rescue in the future. However, the operation of pericardiocentesis is quite difficult and risky, cheap and effective training model or system is needed. The mastery of this technique among military grass-roots health personnel is far from enough. This paper reviews the current research on pericardiocentesis in peacetime training and wartime application at home and abroad, and puts forward feasible suggestions to build a complete training and application system, so as to improve the mastery of ultrasound-guided pericardiocentesis among military grass-roots health personnel.
Key words:  pericardiocentesis  ultrasound-guided  battlefield rescue  training