Huang Peizhen, Zheng Bin, Liu Shan, Xu Lin, Chen Chengchun, Zhan Shubei
Department of Ultrasound and Imaging, Wenzhou Central Hospital, Wenzhou, China.
Wenzhou Medical University, Wenzhou, China.
Front Genet. 2022 Jun 8;13:894716. doi: 10.3389/fgene.2022.894716. eCollection 2022.
As an important means of physical examination, palpation is usually limited to the physical examination before surgery and used as an auxiliary method for disease diagnosis in the field of surgery. In practice, palpation is also used in every aspect of the surgical procedure, and its application is of great significance to surgery. The purpose of this study was to investigate the ability of ultrasound imaging to assess the ability of rotating physicians to locate musculoskeletal structures by palpation. Rotating physicians were asked to palpate and locate the long head tendon of the biceps (LHB), posterior tibialis (TPT), acromioclavicular joint (ACJ), and medial tibiofemoral joint (TFJ) spaces on two volunteer models. After positioning, a truncated steel needle was attached to the skin and parallel to the palpable structure, and the position of the steel needle relative to the designated structure was assessed by ultrasound imaging, using the Cohen kappa test to study the inter-rater agreement. The results showed that the assessor's Kappa coefficient for judging the location of all structures was 0.816, LHB was 1.00, TPT was 0.912, ACJ gap was 0.796, and TFJ medial space was 0.844, and the success rate of palpation for TPT was 62.2%, TFJ medial space was 37.8%, ACJ clearance was 24.3%, and LHB was 8.1%. In conclusion, the teaching methods of anatomy and palpation skills need further improvement, and ultrasound imaging is an effective tool for assessing palpation skills.
触诊作为体格检查的重要手段，通常局限于手术前的体格检查，并作为外科领域疾病诊断的辅助方法。在实际操作中，触诊也应用于手术过程的各个方面，其应用对手术具有重要意义。本研究的目的是调查超声成像评估轮转医生通过触诊定位肌肉骨骼结构的能力。要求轮转医生在两名志愿者模型上触诊并定位肱二头肌长头肌腱（LHB）、胫后肌（TPT）、肩锁关节（ACJ）和胫股内侧关节（TFJ）间隙。定位后，将一根截断的钢针附着于皮肤上并与可触及结构平行，通过超声成像评估钢针相对于指定结构的位置，使用Cohen κ检验研究评估者间的一致性。结果显示，评估者判断所有结构位置的Kappa系数为0.816，LHB为1.00，TPT为0.9１2，ACJ间隙为0.796，TFJ内侧间隙为0.844，TPT触诊成功率为62.2%，TFJ内侧间隙为37.8%，ACJ间隙为24.3%，LHB为8.1%。总之，解剖学和触诊技能的教学方法需要进一步改进，超声成像是评估触诊技能的有效工具。
