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قطب علمی آموزش الکترونیکی دانشگاه علوم پزشکی شیراز


Untitled document

در این مبحث می توانید در مورد اکوکاردیوگرافی، انواع آن، دلائل و چگونگی انجام آن اطلاعاتی کسب نمایید.










در این مبحث به این سوالات شما پاسخ داده می شود:

1.        اکوکاردیوگرافی (اکو) چیست؟

2.        دلائل انجام اکوکاردیوگرافی چیست؟

3.        اکوکاردیوگرافی چگونه انجام می‌شود؟

4.        اکوکاردیوگرافی از طریق مری چیست؟

5.        آمادگی مورد نیاز برای اکوکاردیوگرافی چیست؟

6.        در طی انجام این اقدام تشخیصی بیمار چه احساسی دارد؟

7.        عوامل خطر این اقدام تشخیصی چیست؟

8.        توجهات مربوط به این اقدام تشخیصی کدامند؟

9.        نتایج طبیعی در این اقدام تشخیصی چیست؟

10.     نتایج غیرطبیعی در این اقدام تشخیصی چیست؟


1. اکوکاردیوگرافی (اکو) چیست؟

اکو تستی است که در آن با استفاده از امواج فراصوتی تصویر متحرکی از قلب تهیه می‌شود. عکسی که از این طریق تهیه می‌شود جزئیات بیشتری را نسبت به عکس سادۀ رادیولوژی نشان می‌دهد. این عکس ساختار و عملکرد قلب را نشان داده، به‌علاوه فرد را در خطر مواجه با اشعۀ رادیولوژیک قرار نمی‌دهد. در یک اکوی معمولی عکس‌های دوبعدی از قلب تهیه می‌شود.




2. دلائل انجام اکوکاردیوگرافی چیست؟

معمولاً برای بررسی حفره‌ها و دریچه‌ها و عروق بزرگ خونی قلب با استفاده از یک روش غیرتهاجمی از این تست استفاده می‌شود. در اکو موارد زیر مشخص می‌شوند:

  • صداهای غیرطبیعی قلب
  • دریچه‌های غیرطبیعی قلب
  • عملکرد پمپاژ خون توسط قلب در افراد دچار نارسایی قلبی
  • آسیب عضلات قلب در بیمارانی که سابقه حملۀ قلبی داشته‌اند.
  • عفونت پرده اطراف قلب
  • عفونت دریچه‌های قلب
  • وجود لختۀ خون یا آمبولی پس از سکته
  • بیماری‌های قلبی مادرزادی
  • فیبریلاسیون دهلیزی
  • افزایش فشار ریوی


3. اکوکاردیوگرافی چگونه انجام می‌شود؟


این تست توسط یک فرد آموزش دیده انجام می‌شود. سپس پزشک قلب نتایج به دست‌آمده را بررسی کرده و تفسیر می‌کند.

با استفاده از وسیله‌ای به‌نام ترانس دیوسر که یک نوع میکروفن خاص است، امواج صوتی با فرکانس بالا تولید شده و به سمت قلب فرستاده می‌شود. برای هدایت امواج، ترانس دیوسر بر روی دنده‌ها در نزدیکی سینه گذاشته می‌شود و در جهات مختلفی چرخانیده می‌شود. سپس امواج بازگشت یافته از بافت‌های مختلف، دریافت شده و در کامپیوتر ذخیره شده و مورد تجزیه و تحلیل قرار می‌گیرد.

با استفاده از وسیله‌ای به‌نام ترانس دیوسر که یک نوع میکروفن خاص است، امواج صوتی با فرکانس بالا تولید شده و به سمت قلب فرستاده می‌شود. برای هدایت امواج، ترانس دیوسر بر روی دنده‌ها در نزدیکی سینه گذاشته می‌شود و در جهات مختلفی چرخانیده می‌شود. سپس امواج بازگشت یافته از بافت‌های مختلف، دریافت شده و در کامپیوتر ذخیره شده و مورد تجزیه و تحلیل قرار می‌گیرد.

با استفاده از اکوکاردیوگرام پزشک ضربان قلب و بسیاری از ساختارهای قلب را مورد بررسی قرار می‌دهد. بعضی اوقات ریه‌ها، دنده‌ها یا سایر بافت‌های‌ بدن مانع تهیه عکس واضحی از عملکرد قلب می‌شوند. در چنین مواردی مسئول سونوگرافی ممکن است از مقدار کمی از ماده‌ای که موجب تمایز بهتر عکس می‌شود استفاده کند، که معمولا این ماده از طریق رگ تزریق می‌شود. در موارد بسیار نادر از یک روش تهاجمی‌تر اکو که اکو از طریق مری است، استفاده می‌شود.


echo34. اکوکاردیوگرافی از طریق مری چیست؟

اکوکاردیوگرافی از طریق مری معمولاً توسط پزشک در موارد زیر درخواست می‌شود:

در مواردی که اکوی معمولی به دلایل مختلف از قبیل سینۀ بشکه‌ای شکل، بیماری ریوی یا چاقی از وضوح کافی برخوردار نباشد.

در مواردی که عکس‌های واضح‌تری از نواحی خاص مورد لزوم است.

در روش اکوکاردیوگرافی از طریق مری، ناحیه انتهای حلق (ته گلوی) بیمار بی‌حس شده و یک وسیلۀ کوچک جهت تولید امواج فراصوتی به قسمت انتهای مری هدایت می‌شود. از این روش برای به دست‌آوردن یک اکوی دوبعدی واضح از قلب استفاده می‌شود.


5. آمادگی مورد نیاز برای اکوکاردیوگرافی چیست؟

آمادگی خاصی برای انجام اکو معمولی مورد نیاز نمی‌باشد اما در اکو از طریق مری، بیمار باید از نیمه شب گذشته چیزی به‌ جز داروهایش نخورد.


6echo1. در طی انجام این اقدام تشخیصی بیمار چه احساسی دارد؟

از بیمار خواسته می‌شود که لباس‌های قسمت بالاتنه را خارج کرده و بر روی میز معاینه به پشت دراز بکشد. برای گرفتن نوار قلب الکترودها روی قفسۀ سینه چسبانیده می‌شوند. ژل مخصوصی بر روی ترانس دیوسر یا روی قفسۀ سینه مالیده شده و سپس ترانس دیوسر بر روی قفسۀ سینه قرار می‌گیرد. بیمار احساس فشار اندکی به‌دلیل وجود ترانس دیوسر بر روی قفسۀ سینه خواهد داشت. ممکن است از بیمار درخواست شود که به شیوۀ خاص نفس بکشد و یا به سمت چپ بچرخد.


7. عوامل خطر این اقدام تشخیصی چیست؟

عامل خطر شناخته شده ای در رابطه با این تست تشخیصی وجود ندارد.


8. توجهات مربوط به این اقدام تشخیصی کدامند؟

نتایج غیرطبیعی ممکن است نشان دهنده اختلالات دریچه قلب، اختلالات عضله قلب، مایع دور قلب یا سایر اختلالات قلبی باشد.

9. نتایج طبیعی در این اقدام تشخیصی چیست؟

یک اکوی طبیعی نشان دهنده دریچه ها، حفره هاو حرکات طبیعی قلب می باشد.


10. نتایج غیرطبیعی در این اقدام تشخیصی چیست؟

یک اکو غیرطبیعی معناهای مختلفی ممکن است داشته باشد. در برخی از موارد اختلالات غیرطبیعی، خیلی جزئی هستند و خطر زیادی ایجاد نمی‌کنند. در حالی‌که برخی از اختلالات دیگر علائم بیماری‌های قلبی جدی هستند که نیاز به بررسی‌های بیشتر توسط پزشک دارند. بنابراین این نکته حائز اهمیت است که بیمار در رابطه با نتایج اکو با پزشک مشورت داشته باشد.

بنابراین این نکته حائز اهمیت است که بیمار در رابطه با نتایج اکو با پزشک مشورت داشته باشد.


برای دیدن اسلاید اینجا کلیک کنید

ویدیو این قسمت در دست تهیه است.


متخصص علمی محتوا: دکتر رضا معرف

گردآوری محتوا و طراح آموزشی: فاطمه شیرازی

تولیدفیلم آموزشی:شرکت داتیس

بازبینی نهایی: دکتر مانوش مهرابی



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shahzad , ژوئن 01, 2012
salam ,zemne arze khaste nabashid,mikhastam darkhast konam k kiliphaye videoi ro hamzaman bamatlab b namayesh bogzarid,v hamchenin dorose olom paye ro ham dar liste mataleb gharar dahaid. sepasgozar
elahesadati , اكتبر 31, 2011

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