作者从临床医生的角度,介绍了颈部肿块诊断中的触诊经验。 1.如同腹腔炎症时腹肌紧张性增高的情况一样,颈部也存在“肌卫”。在触诊时,最好先用手指全面地作左右比较触诊。主诉患侧肩关节活动不利的患者不少,对这样的病人,如胸锁乳突肌触及强直,检查者总应想到该侧有淋巴结转移或复发的可能而再加以诊察。 2.颈动脉触诊对手术甚为重要。颈部恶性肿瘤的手术原则上是做全颈部廓清术。切除范围虽大,但一般不留显著的后遗症。但切除颈动脉时,常招致偏瘫,故术前必须想到后遗症的危险。肿瘤浸润颈动脉时,预后不良。此时须以食指和中指从下颌至锁骨上窝按压检查是否能触到 From the clinician’s point of view, the author describes the experience of palpation in the diagnosis of neck masses. 1. As with the increase in abdominal muscle tension during celiac inflammation, there is also “myophytic” in the neck. At the time of palpation, it is best to compare the left and right palpation with your fingers. There are many patients complaining of unfavorable activities of ipsilateral shoulder joints. For such patients, such as sternocleidomastoid muscle rigidity, the examiner should always think of the possibility of lymph node metastasis or recurrence and then he will be examined again. 2. Carotid palpation is very important for surgery. The operation of neck cancer is in principle a neck dissection. Although the scope of resection is large, no significant sequelae are generally left. However, when the carotid artery is removed, hemiplegia often occurs. Therefore, the risk of sequelae must be considered before surgery. When the tumor infiltrates the carotid artery, the prognosis is poor. At this point, you must press the index finger and middle finger from the lower jaw to the upper clavicle to see if you can touch it.