Division of Veterinary Clinical Sciences, R(D)SVS, University of Edinburgh, Easter Bush, Roslin, Midlothian, Scotland EH25 9RG, UK.
Vet J. 2010 Oct;186(1):53-7. doi: 10.1016/j.tvjl.2009.07.020. Epub 2009 Sep 3.
The utility of routine auscultation to detect and characterise the nature of a range of superficial lung and pleural pathologies in domestic sheep was assessed using ultrasonographic examination to indicate and localise pathologies pre-mortem. Necropsy examination was then used to fully characterise the nature and extent of the lesions. Auscultation recordings were made from 10 normal sheep with no clinical evidence of respiratory disease and with absence of significant superficial lung pathology, which was confirmed initially by ultrasound examination and subsequently at necropsy examination. A further two sheep with endotoxaemia and 30 sheep with well-defined lung lesions were also examined. Increased audibility of normal lung sounds in 4/10 normal sheep was associated with tachypnoea as a consequence of handling and transport during hot weather and was also observed in the two sheep with endotoxaemia. Moderate to severe coarse crackles detected in all advanced cases of ovine pulmonary adenocarcinoma (n=16) were audible over an area larger than the lesion distribution identified during ultrasound examination, and confirmed later at necropsy. Auscultation did not detect abnormal sounds in any of the five sheep with focal pleural abscesses (up to 10 cm diameter). Unilateral pyothorax caused attenuation of sounds relative to the contra-lateral normal lung in all three sheep with this condition. Marked fibrinous pleurisy caused attenuation of sounds relative to normal areas of lung in six sheep. No sounds resembling the description of pleural frictions rubs were heard in the sheep with marked fibrinous pleurisy (n=6) or associated with focal pleural abscesses (n=5). Routine interpretation of auscultated sound did not allow the presence of superficial lung pathology or its distribution to be accurately defined in the respiratory diseases represented in this study.
本研究旨在评估常规听诊在检测和描述绵羊肺部和胸膜浅表病变性质方面的作用，使用超声检查来提示和定位病变，然后通过尸检来全面描述病变的性质和范围。对 10 只无临床呼吸疾病且无明显肺部浅表病变的正常绵羊进行听诊，这些绵羊在超声检查和随后的尸检中均未发现明显病变。另外还对 2 只内毒素血症绵羊和 30 只肺部明确病变绵羊进行了检查。在 10 只正常绵羊中，有 4 只在天气炎热时因处理和运输而出现呼吸急促，导致正常肺部声音的可闻度增加，这 4 只绵羊也患有内毒素血症。在所有晚期绵羊肺腺癌（n=16）病例中均能听到中等至重度粗湿啰音，其可闻范围大于超声检查确定的病变分布范围，并在尸检时得到证实。在 5 例有局灶性胸膜脓肿（直径达 10 厘米）的绵羊中，听诊均未检测到异常声音。在所有 3 例单侧脓胸绵羊中，单侧脓胸导致患侧肺部声音相对于健侧正常肺部减弱。在 6 例有明显纤维素性胸膜炎的绵羊中，纤维素性胸膜炎导致患侧肺部声音相对于正常区域减弱。在有明显纤维素性胸膜炎（n=6）或伴有局灶性胸膜脓肿（n=5）的绵羊中，均未听到类似胸腔摩擦音的声音。在本研究中，常规听诊对提示和描述呼吸疾病中肺部浅表病变的存在及其分布的作用有限。
