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皮下气肿,一种不同的诊断方式。

Subcutaneous emphysema, a different way to diagnose.

作者信息

Medeiros Bruno José da Costa

机构信息

Instituto de Cirurgia do Estado do Amazonas, Amazonas, AM, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2018 Feb;64(2):159-163. doi: 10.1590/1806-9282.64.02.159.

Abstract

INTRODUCTION

Subcutaneous emphysema (SE) is a clinical condition that occurs when air gets into soft tissues under the skin. This can occur in any part of the body depending on the type of pathology. The most common site is under the skin that covers the chest wall or neck. It is characterized by painless swelling of tissues. The classic clinical sign is a crackling sensation upon touch, resembling that of touching a sponge beneath your fingers.

OBJECTIVE

To describe a new way to diagnose subcutaneous emphysema.

METHOD

Our finding was a matter of serendipity while inspecting a patient with subcutaneous emphysema using a stethoscope. Instead only hearing the patient's chest, the stethoscope was gently pressed against the skin with SE and so we were able to detect a different sound.

RESULTS

This new way to diagnose subcutaneous emphysema consists in pressing the diaphragm part of stethoscope against the patient's skin where SE is supposed to be. Thus, we are able to hear a sound of small bubbles bursting. Crackle noise has an acoustic emission energy that varies between 750-1,200 Hz, considered high frequency.

CONCLUSION

Although currently the use of imaging methods is widespread worldwide, we would like to strengthen the value of clinical examination. Auscultation is an essential diagnostic method that has become underestimated with the advances of healthcare and medicine as a whole. We therefore propose a different approach to diagnose SE.

摘要

引言

皮下气肿(SE)是一种临床病症,当空气进入皮下软组织时就会发生。根据病理类型的不同,这种情况可发生在身体的任何部位。最常见的部位是覆盖胸壁或颈部的皮肤下方。其特征是组织无痛性肿胀。典型的临床体征是触摸时有捻发音,类似于手指下触摸海绵的感觉。

目的

描述一种诊断皮下气肿的新方法。

方法

我们的发现是在使用听诊器检查一名皮下气肿患者时偶然获得的。听诊器不是只听患者的胸部,而是轻轻按压在有皮下气肿的皮肤上,这样我们就能检测到一种不同的声音。

结果

这种诊断皮下气肿的新方法是将听诊器的膜型体件按压在患者疑似有皮下气肿的皮肤上。这样,我们就能听到小气泡破裂的声音。爆裂音的声发射能量在750 - 1200赫兹之间变化,属于高频。

结论

虽然目前成像方法在全球范围内广泛使用,但我们希望强化临床检查的价值。听诊是一种重要的诊断方法,但随着整个医疗保健和医学的进步,它已被低估。因此,我们提出一种不同的方法来诊断皮下气肿。

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