Mori M
Tokyo National Chest Hospital, Kiyose.
Rinsho Byori. 1994 Apr;42(4):396-400.
Because of technical difficulties, the study of lung sounds has been neglected for the last 200 years since the age of Laennec. However, recent advances in signal processing and in technology have made it possible to record lung sounds routinely at the bedside or in clinical laboratories. Lung sound analysis has many advantages because it is safe, non-invasive, low-cost, and repeatable. Normal lung sounds can be classified into tracheal, bronchial, and alveolar (vesicular) sounds. They are all common in that the origin of the sound is the turbulence in the airways. The most important and convenient way of distinguishing them is the place where they are heard and the difference in intensity in relation to breathing cycle. Alveolar sounds are heard at the bases and are definitely larger during inspiration, while bronchial sounds are heard at the apex, over the sternum and inter-scapular area, and are equal or louder during expiration. The abnormal, or adventitious lung sounds are classified into continuous and discontinuous. Wheezes are most common continuous sounds. However, in patients with stenosis of trachea or major bronchus large continuous sounds often referred to as rhonchi are heard. They are easily heard over the neck and are important clinical signs which nurses and laboratory technicians must be aware of. By the use of adaptive digital filters we can reduce contaminating noises without the use of sound proof rooms. Because of many advantages, the lung sound analysis has a promising future as a method to supplement other pulmonary function studies.
自雷奈克时代以来的过去200年里,由于技术困难,肺部声音的研究一直被忽视。然而,信号处理和技术方面的最新进展使得在床边或临床实验室常规记录肺部声音成为可能。肺部声音分析具有许多优点,因为它安全、无创、低成本且可重复。正常肺部声音可分为气管音、支气管音和肺泡(小泡)音。它们的共同之处在于声音的起源是气道中的湍流。区分它们最重要且方便的方法是听诊部位以及与呼吸周期相关的强度差异。肺泡音在肺底部听到,吸气时明显更大,而支气管音在肺尖、胸骨上方和肩胛间区域听到,呼气时相等或更大。异常或附加肺部声音分为连续性和非连续性。哮鸣音是最常见的连续性声音。然而,在气管或主支气管狭窄的患者中,常可听到通常称为鼾音的较大连续性声音。在颈部很容易听到,是护士和实验室技术人员必须注意的重要临床体征。通过使用自适应数字滤波器,我们可以在不使用隔音室的情况下减少干扰噪声。由于具有许多优点,肺部声音分析作为补充其他肺功能研究的一种方法具有广阔的前景。