Hedayioglu F L, Mattos S S, Moser L, de Lima M E
Maternal-Fetal Cardiac Unit, Royal Portuguese Hospital, Av. Portugal, 163, Recife PE, 50090.900, Brazil.
Indian J Exp Biol. 2007 Jan;45(1):86-92.
Over the years, many attempts have been made to develop special stethoscopes for the teaching of auscultation. The objective of this article is to report on the experience with the development and implementation of an electronic stethoscope and a virtual library of cardiac sounds. There were four stages to this project: (1) the building of the prototype to acquire, filter and amplify the cardiac sounds, (2) the development of a software program to record, reproduce and visualize them, (3) the testing of the prototype in a clinical scenario, and (4) the development of an internet site, to store and display the sounds collected. The first two stages are now complete. The prototype underwent an initial evaluation in a clinical scenario within the Unit and during virtual out-patient clinical sessions. One hundred auscultations were recorded during these tests. They were reviewed and discussed on-line by a panel of experience cardiologists during the sessions. Although the sounds were considered "satisfactory" for diagnostic purposes by the cardiology team, they identified some qualitative differences in the electronic recorded auscultations, such as a higher pitch of the recorded sounds. Prospective clinical studies are now being conducted to further evaluate the interference of the electronic device in the physicians' capability to diagnose different cardiac conditions. An internet site (www.caduceusvirtual.com.br/ auscultaped) was developed to host these cardiac auscultations. It is set as a library of cardiac sounds, catalogued by pathologies and already contains examples from auscultations of the majority of common congenital heart lesions, such as septal defects and valvar lesions.
多年来，人们多次尝试开发用于听诊教学的特殊听诊器。本文的目的是报告电子听诊器和心音虚拟库的开发与实施经验。该项目有四个阶段：（1）构建用于采集、过滤和放大心音的原型；（2）开发用于记录、再现和可视化心音的软件程序；（3）在临床场景中对原型进行测试；（4）开发一个网站来存储和展示收集到的声音。前两个阶段现已完成。该原型在科室内部的临床场景以及虚拟门诊临床课程中进行了初步评估。在这些测试中记录了100次听诊。经验丰富的心脏病专家小组在课程期间对这些记录进行了在线审查和讨论。尽管心脏病学团队认为这些声音在诊断方面“令人满意”，但他们发现电子记录的听诊存在一些质量差异，例如记录声音的音调较高。目前正在进行前瞻性临床研究，以进一步评估电子设备对医生诊断不同心脏疾病能力的干扰。已开发了一个网站（www.caduceusvirtual.com.br/auscultaped）来存放这些心音听诊记录。它被设置为一个心音库，按病理情况分类，并且已经包含了大多数常见先天性心脏病病变（如间隔缺损和瓣膜病变）听诊的示例。
