Chongtham D S, Singh M M, Kalantri S P, Pathak S
Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Natl Med J India. 1997 Jan-Feb;10(1):13-4.
Shifting dullness and fluid wave are two techniques commonly used to detect ascites. However, these may fail to detect moderate or minimal ascites. Ultrasonography is a good non-invasive method to detect ascites but may not be available in distant rural areas of India. We assessed the utility of the puddle sign and auscultatory percussion for detecting ascites.
Sixty-six patients with suspected ascites were included in the study. Those with a previous history of ascites, or therapeutic paracentesis and in whom ascites was detected by shifting dullness or fluid wave were excluded. The puddle sign and auscultatory percussion were elicited in all the patients. Ultrasonography was used as the gold standard. To eliminate any observer bias the investigators were blinded to each others' findings.
Auscultatory percussion had a greater sensitivity (65.7% v. 45%, p < 0.05) but a lower specificity than the puddle sign (48.4% v. 67.7%, p < 0.05). There were no significant differences between positive and negative predictive values and the positive and negative likelihood ratios.
Auscultatory percussion is a better method than puddle sign for detecting ascites as it has a greater sensitivity.
移动性浊音和液波震颤是常用于检测腹水的两种方法。然而，这些方法可能无法检测出中度或少量腹水。超声检查是检测腹水的一种良好的非侵入性方法，但在印度偏远农村地区可能无法使用。我们评估了水坑征和听诊叩诊法检测腹水的效用。
66例疑似腹水患者纳入本研究。排除有腹水既往史、治疗性腹腔穿刺术史以及通过移动性浊音或液波震颤检测出腹水的患者。对所有患者进行水坑征和听诊叩诊检查。以超声检查作为金标准。为消除任何观察者偏倚，研究人员对彼此的检查结果不知情。
听诊叩诊的敏感性更高（65.7%对45%，p<0.05），但特异性低于水坑征（48.4%对67.7%，p<0.05）。阳性和阴性预测值以及阳性和阴性似然比之间无显著差异。
听诊叩诊检测腹水的方法比水坑征更好，因为其敏感性更高。
