레지던트들이 스스로 복부초음파를 할 때 몸에 익혀야 할 기본을 『철칙』 형식으로 정리한 책을 만들고 싶었어요. 레지던트들이 고민하고, 헤매기 쉬운 주제를 다루어 증례를 바탕으로 실질적인 대응 방안을 제시할 수 있는 내용으로 검토해 주시면 어떨까요? 내일부터 직접 프로브를 들고 맞추어보고 싶다는 생각이 들 수 있는 책을 목표로 하고 있습니다.
기초편에서는 복부초음파 수련의의 마음가짐으로 레지던트 여러분들이 꼭 알아두어야 할 초음파 검사의 기본 사항에 대해 설명하였습니다. POCUS의 개념, 그 발전의 원동력인 포터블 초음파 진단기기(포켓 에코)에 대해서도 다루고 있습니다.
실습편은 세 파트로 나누었습니다. ‘1 초음파 해부 및 스캔법’에서는 거의 모든 영역의 기본 검사법을 집약하였습니다. 본서의 특징 중 하나인 영상과 수기(프로브 조작)를 연계한 동영상을 풍부하게 준비하여, 스캔법의 요령을 내레이션으로 해설하고 있습니다. 교재와 동영상을 병용하는 것으로 초음파 검사 수기를 쉽게 자가 학습할 수 있도록 하였습니다. 검사실에서의 복부초음파 교육 전, 병상에서 POCUS를 시작하기 전 자가 학습 교재로도 꼭 활용하시기 바랍니다. 분명 원활하게 교육을 진행할 수 있을 것입니다.
‘2 부위별 · 영역별 초음파 실습’은 복부초음파 교재의 핵심입니다. 지면 관계상 모든 질환을 다 다룰 수는 없어서 흔한 질환, 일차진료나 응급실에서 많이 접하게 되는 질환을 중심으로 다루었습니다. 철칙 형식이므로 각 저자가 전달하고자 하는 포인트가 깔끔하게 정리되어 있어 이해하기 쉽다고 생각합니다.
‘3 증상별 초음파 실습’에서는 병상에서 진료하는 의사의 관점에서 증상에 근거한 POCUS의 활용을 의식하여 집필하였습니다. POCUS에 정통한 종합진료, 응급진료를 전문으로 하는 선생님들이 집필을 맡았습니다.
기초편 1
1 복부초음파 수련의 마음가짐········································································ 2
2 초음파 물리학의 기초지식 ·········································································· 4
3 프로브와 오리엔테이션··············································································· 12
4 초음파 진단기기 본체의 취급···································································· 19
5 복부초음파에서 볼 수 있는 허상······························································· 30
6 초음파 검사 및 의료 안전·········································································· 41
7 피검사자에 대한 사전 요청 및 배려·························································· 46
8 체계적 초음파 검사 및 Point-of-Care Ultrasound(POCUS)·························· 51
9 휴대용 초음파 진단기기·············································································· 55
실습편 1 초음파 해부 및 스캔법 59
복부초음파의 포인트······················································································ 61
초음파 해부 및 스캔법·················································································· 63
1 담낭 · 간외담관············································································································ 63
2 간장······························································································································· 67
3 췌장······························································································································· 76
4 비장······························································································································· 82
5 소화관··························································································································· 84
6 복부혈관······················································································································· 96
7 신장 · 방광··················································································································· 98
8 복강····························································································································· 105
9 자궁 · 부속기·············································································································· 107
실습편 2 부위별 · 영역별 초음파 실습 109
1 담낭 · 간외담관······················································································· 110
2 간장·········································································································· 119
3 췌장·········································································································· 133
4 비장·········································································································· 141
5 소화관······································································································ 147
6 복부혈관··································································································· 160
7 신장 · 방광······························································································ 164
8 부인과······································································································ 173
9 소아·········································································································· 184
실습편 3 증상별 초음파 실습 193
1 상복부 통증····························································································· 194
2 하복부 통증····························································································· 204
3 측복부 통증····························································································· 214
4 황달 ········································································································ 226
5 발열·········································································································· 236
6 외상·········································································································· 248
7 내인성 쇼크····························································································· 256
Column
ALARA(as low as reasonably achievable)의 원칙················································· 41
SARS-CoV-2 감염 확산 시···························································································· 43
seven-eleven rule········································································································· 112
상승 비후···················································································································· 115
종스캔························································································································· 179
횡스캔························································································································· 179
부인과 경복부초음파의 관찰 순서············································································ 180
Howship-Romberg 징후······························································································· 212
초음파와 다른 모달리티의 구분················································································ 217
여성 환자의 측복부 통증에 대한 함정(pitfall)··························································· 224
무결석성 담낭염(acalculous cholecystitis)···································································· 244
패혈성 쇼크와 초음파································································································ 266
찾아보기······················································································································ 269
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