Recommendations on the Use of Ultrasound Guidance for Adult Abdominal Paracentesis: A Position Statement of the Society of Hospital Medicine.
Recommendations on the Use of Ultrasound Guidance for Adult Abdominal Paracentesis: A Position Statement of the Society of Hospital Medicine.
复制标题
DOI：
10.12788/jhm.3095
复制
发表时间：
2019-01-02
影响因子：
2.6
通讯作者：
Soni, Nilam J
中科院分区：
文献类型：
--
作者：
Cho, Joel;Jensen, Trevor P;Soni, Nilam J
1.我们建议穿刺时应使用超声引导，以减少严重并发症的风险，最常见的是出血。2.我们建议，应使用超声引导，以避免试图在患者腹腔内游离液量不足，以排出穿刺。3.我们建议，超声引导下应使用穿刺术，以提高整个过程的成功率。4.我们建议应使用超声来评估腹腔内游离液体的体积和位置，以指导临床决策，在哪里可以安全地进行穿刺。5.我们建议根据积液的大小、腹壁的厚度和与腹部器官的接近程度，使用超声来确定穿刺部位。6.我们建议使用彩色血流多普勒超声评价穿刺针插入部位，以识别并避免沿预期穿刺针轨迹沿着的腹壁血管。7.我们建议应在多个平面上评价穿刺针插入部位，以确保从下方腹部器官中清除，并沿预期的穿刺针轨迹沿着检测任何腹壁血管。8.我们建议在进行手术前立即用超声标记针头插入部位，在标记部位和进行手术之间，患者应保持相同的位置。9.我们建议，当液体收集量少或难以进入时，应考虑使用实时超声引导进行穿刺。10.我们建议专门的培训课程，包括教学法，对患者的监督实践，和基于模拟的实践，应用来教新手如何进行超声引导穿刺。11.我们建议，应使用基于模拟的做法，如果可用的话，以促进收购所需的知识和技能进行超声引导穿刺。12.我们建议在对患者独立进行手术之前，应证明其具有进行超声引导穿刺术的能力。
1. We recommend that ultrasound guidance should be used for paracentesis to reduce the risk of serious complications, the most common being bleeding. 2. We recommend that ultrasound guidance should be used to avoid attempting paracentesis in patients with an insufficient volume of intraperitoneal free fluid to drain. 3. We recommend that ultrasound guidance should be used with paracentesis to improve the success rates of the overall procedure. 4. We recommend that ultrasound should be used to assess the volume and location of intraperitoneal free fluid to guide clinical decision making of where paracentesis can be safely performed. 5. We recommend that ultrasound should be used to identify a needle insertion site based on size of the fluid collection, thickness of the abdominal wall, and proximity to abdominal organs. 6. We recommend that the needle insertion site should be evaluated using color flow Doppler ultrasound to identify and avoid abdominal wall blood vessels along the anticipated needle trajectory. 7. We recommend that a needle insertion site should be evaluated in multiple planes to ensure clearance from underlying abdominal organs and detect any abdominal wall blood vessels along the anticipated needle trajectory. 8. We recommend that a needle insertion site should be marked with ultrasound immediately before performing the procedure, and the patient should remain in the same position between marking the site and performing the procedure. 9. We recommend that using real-time ultrasound guidance for paracentesis should be considered when the fluid collection is small or difficult to access. 10. We recommend that dedicated training sessions, including didactics, supervised practice on patients, and simulation-based practice, should be used to teach novices how to perform ultrasound-guided paracentesis. 11. We recommend that simulation-based practice should be used, when available, to facilitate acquisition of the required knowledge and skills to perform ultrasoundguided paracentesis. 12. We recommend that competence in performing ultrasound-guided paracentesis should be demonstrated prior to independently performing the procedure on patients.