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佩戴外科口罩对听诊评估没有显著影响。

Wearing surgical face mask has no significant impact on auscultation assessment.

机构信息

Division of Pulmonology, Department of Internal Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.

School of Medicine, University of Zagreb, Zagreb, Croatia.

出版信息

PeerJ. 2024 May 24;12:e17368. doi: 10.7717/peerj.17368. eCollection 2024.

Abstract

OBJECTIVE

During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung auscultation, were done while patients were wearing surgical face masks. The aim of this study was to investigate whether mask wearing has an impact on pulmonologist assessment during auscultation of the lungs.

METHODS

This was a repeated measures crossover design study. Three pulmonologists were instructed to auscultate patients with previously verified prolonged expiration, wheezing, or crackles while patients were wearing or not wearing masks (physician and patients were separated by an opaque barrier). As a measure of pulmonologists' agreement in the assessment of lung sounds, we used Fleiss kappa (K).

RESULTS

There was no significant difference in agreement on physician assessment of lung sounds in all three categories (normal lung sound, duration of expiration, and adventitious lung sound) whether the patient was wearing a mask or not, but there were significant differences among pulmonologists when it came to agreement of lung sound assessment.

CONCLUSION

Clinicians and health professionals are safer from respiratory infections when they are wearing masks, and patients should be encouraged to wear masks because our research proved no significant difference in agreement on pulmonologists' assessment of auscultated lung sounds whether or not patients wore masks.

摘要

目的

在 COVID-19 大流行期间,全民戴口罩成为主要的公共卫生干预措施之一。正因为如此,大多数体格检查,包括肺部听诊,都是在患者佩戴外科口罩的情况下进行的。本研究旨在探讨戴口罩是否会影响听诊肺部时的肺科医生评估。

方法

这是一项重复测量交叉设计研究。三位肺科医生被指示在患者佩戴或不佩戴口罩(医生和患者被不透明屏障隔开)的情况下听诊先前证实呼气延长、喘息或爆裂音的患者。作为衡量肺科医生对肺部声音评估一致性的指标,我们使用了 Fleiss kappa(K)。

结果

在所有三个类别(正常肺部声音、呼气时间和附加肺部声音)中,患者是否佩戴口罩对医生评估肺部声音的一致性均无显著差异,但在肺科医生评估肺部声音的一致性方面存在显著差异。

结论

当临床医生和卫生专业人员佩戴口罩时,他们可以更安全地免受呼吸道感染,并且应该鼓励患者佩戴口罩,因为我们的研究证明,无论患者是否佩戴口罩,肺科医生对听诊肺部声音的评估一致性均无显著差异。

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