心肺外听诊的临床意义

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目前临床上往往只注意心肺的听诊,而对心肺外听诊的实用价值不够重视。本文拟就此方面作一介绍。一、头部听诊:头部听诊配合叩诊可早期发现颅内肿块,特别是硬膜下血肿。检查方法:患者取仰卧或坐位,头部向前,检查者面对患者或站在一侧,以手指轻而均匀地叩击距眉弓上缘3cm 中线处,另一手持听诊器在头部两侧对称部位进行听诊,比较二侧声音的差异。听诊部位从耳轮上缘水平开始,由额部到枕部顺序进行,渐渐升高听诊平面直到顶部。为了使结果准确,听诊器的钟面必须与头皮密切接触,并且每次移动的距离不大于钟膜的直径。正常时,二侧声音相同,类似“清音”,如一侧出现明显“实音”或“浊音”则为阳性,提示该侧有肿块性病变。 Currently, clinical cardiopulmonary auscultation is often only paid attention to, but not enough emphasis on the practical value of cardiopulmonary auscultation. This article intends to make an introduction in this respect. First, the head auscultation: Head auscultation with percussion early detection of intracranial masses, especially subdural hematoma. Inspection methods: patients supine or sitting position, the head forward, the examiner to face the patient or standing on the side of the finger gently and evenly tapping the eyebrow arch edge 3cm midline at the other holding a stethoscope in the head two Auscultation of the lateral symmetry, the difference between the two sides of the sound. Auscultation site from the upper edge of the level of the beginning of the ear, from the forehead to the occipital order, and gradually raise the auscultation plane until the top. For accurate results, the stethoscope’s clock face must be in close contact with the scalp, and each time it moves no further than the bell diameter. Normal, the two sides of the same sound, similar to “voiceless”, such as the side of the obvious “real” or “voiced” is positive, suggesting that the side of lumps lesions.
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