胸部听诊（Chest auscultation）.doc

胸部听诊（Chest auscultation） The process right China Academy of Medical Sciences Fuwai Hospital of Cardiovascular Disease (Beijing 100037) It was not until 1816 that Dr. Laennec invented the stethoscope and created the famous indirect auscultation method before abandoning the direct auscultation with the ear directly attached to the chest of the patient, enabling auscultation to enter a glorious era. However, due to the rapid development of modern technology, especially the wide application of echocardiography, stethoscope gradually ignored, auscultation technology gradually abandoned, and even become the decorations in the neck as the doctor. People ask, is there a future for todays stethoscope? Recently, some chest auscultation training investigations have found that the auscultation level of medical students and young doctors is worrying, and some scholars even call for defending Stethoscope, which is not surprising. Due to the age of the older generation physicians, the lack of modern diagnostic techniques and methods, coupled with strict bedside training, enabled them to acquire some difficult skills and experience in auscultation. While we are still here, I would like to talk to young doctors about some ideas, experiences and techniques about auscultation of the chest. First, the feelings in practice Even at the height of the development of sophisticated diagnostic technology today, carefully and accurately auscultation may sometimes give diagnosis of heart and lung diseases brought valuable information and clues, such examples are not individual, only the experience of the case are as follows: (1) a case of smell and apical area of grade /6, III, high-profile, pansystolic murmur to armpit conduction with the first echocardiographic examination found no abnormalities, then common echocardiography, mitral valve that partially ruptured chordae tendineae, a narrow reflux signal along the left atrium the wall has been confirmed with flash. (2) in one case of dilated c