Bakos Z, Vörös K
Clinic for Large Animals, Faculty of Veterinary Science, Szent István University, 2225 Ulló, Dóra major, Hungary.
Acta Vet Hung. 2007 Sep;55(3):277-86. doi: 10.1556/AVet.55.2007.3.1.
Since percussion started to be a method forgotten and not trusted by many practitioners, the aim of the study was to demonstrate whether this procedure could deliver exact data if done accurately and by a practised examiner. The trial presented here included 31 healthy warm-blooded horses. Percussion of the area of cardiac dullness and then echocardiographic imaging of the same region were performed. To obtain the relevant measurement points, the 4th and 5th intercostal spaces (ICS) were used on the left and the 4th ICS on the right side. On the left side, the dorsal border of cardiac dullness was determined in the 4th ICS (1st point). Then the ventral border of the cardiac dullness was determined at the same place (2nd point). This was followed by the examination of the same points in the 5th ICS (3rd and 4th points). The following step was to measure the distance of these points from the ventral border of the thorax, and also that between the 2nd and the 4th points. On the right side the same procedure was used in the 4th ICS only. Mean values/standard errors (in cm) of absolute values of differences between percussional and echocardiographic measurements were as follow. Left side, 4th ICS, dorsal border: 0.8/0.1; ventral border: 0.7/0.1; 5th ICS, dorsal border: 0.8/0.1, ventral border: 0.9/0.2; right side, 4th ICS, dorsal border: 0.8/0.2; ventral border: 0.7/0.1. Due to the close correlation between the results of the two techniques, it is reasonable to consider cardiac percussion as an integrated part of the physical examination.
由于叩诊已开始成为一种被许多从业者遗忘且不信任的方法,本研究的目的是证明如果由经验丰富的检查者准确操作,该方法是否能提供准确的数据。此处展示的试验纳入了31匹健康的温血马。对心浊音区进行叩诊,然后对同一区域进行超声心动图成像。为获取相关测量点,左侧使用第4和第5肋间间隙(ICS),右侧使用第4肋间间隙。在左侧,于第4肋间间隙确定心浊音的背侧边界(第1点)。然后在同一位置确定心浊音的腹侧边界(第2点)。接着在第5肋间间隙检查相同的点(第3和第4点)。接下来的步骤是测量这些点到胸廓腹侧边界的距离,以及第2点和第4点之间的距离。在右侧,仅在第4肋间间隙采用相同的操作。叩诊测量值与超声心动图测量值之间差异绝对值的平均值/标准误差(单位:厘米)如下。左侧,第4肋间间隙,背侧边界:0.8/0.1;腹侧边界:0.7/0.1;第5肋间间隙,背侧边界:0.8/0.1,腹侧边界:0.9/0.2;右侧,第4肋间间隙,背侧边界:0.8/0.2;腹侧边界:0.7/0.1。由于两种技术的结果之间存在密切相关性,将心脏叩诊视为体格检查的一个组成部分是合理的。