吉林医学
吉林醫學
길림의학
JILIN MEDICAL JOURANL
2001年
1期
31-33
,共3页
心肺杂音%心肺摩擦音%喷气性杂音
心肺雜音%心肺摩抆音%噴氣性雜音
심폐잡음%심폐마찰음%분기성잡음
目的：为研讨心肺杂音的产生机理及分类。方法：笔者1963年至1999年潜心研究心脏听诊，对8例病理性心肺杂音细心观察，结合文献。结果：病理性心肺杂音的机理为心搏撞击病肺而产生的喷气性杂音，其分类：①悦耳乐性类蛙鸣样病理性心肺杂音。为心搏撞击肺内巨大气腔而产生。②心肺敲击音。为中量气胸伴不全肺不张受心搏撞击所产生。③心肺弹击音。为心搏撞击左肺舌叶泡性肺气肿所产生。病理性心肺摩擦音：①心肺摩擦音，即胸膜—心包摩擦音。②心肺挤擦音。类心肺摩擦音。为左肺内侧面小量多房包裹性气胸受心脏挤压摩擦所产生。乐性病理性心肺杂音的听诊特点为心尖—心前区响亮、短促、悦耳乐性杂音，多为收缩期，与心音关系不固定、传导广泛无定向性。压胸听诊减弱乃至消失。无震颤及摩擦感。深吸气增强、深呼气末屏气消失。可变性强，动态观察可短时内消失或再现。某一特定体位杂音清楚，变换体位杂音可消失。结论：建议心肺杂音应分类为生理性与病理性。
目的：為研討心肺雜音的產生機理及分類。方法：筆者1963年至1999年潛心研究心髒聽診，對8例病理性心肺雜音細心觀察，結閤文獻。結果：病理性心肺雜音的機理為心搏撞擊病肺而產生的噴氣性雜音，其分類：①悅耳樂性類蛙鳴樣病理性心肺雜音。為心搏撞擊肺內巨大氣腔而產生。②心肺敲擊音。為中量氣胸伴不全肺不張受心搏撞擊所產生。③心肺彈擊音。為心搏撞擊左肺舌葉泡性肺氣腫所產生。病理性心肺摩抆音：①心肺摩抆音，即胸膜—心包摩抆音。②心肺擠抆音。類心肺摩抆音。為左肺內側麵小量多房包裹性氣胸受心髒擠壓摩抆所產生。樂性病理性心肺雜音的聽診特點為心尖—心前區響亮、短促、悅耳樂性雜音，多為收縮期，與心音關繫不固定、傳導廣汎無定嚮性。壓胸聽診減弱迺至消失。無震顫及摩抆感。深吸氣增彊、深呼氣末屏氣消失。可變性彊，動態觀察可短時內消失或再現。某一特定體位雜音清楚，變換體位雜音可消失。結論：建議心肺雜音應分類為生理性與病理性。
목적：위연토심폐잡음적산생궤리급분류。방법：필자1963년지1999년잠심연구심장은진，대8례병이성심폐잡음세심관찰，결합문헌。결과：병이성심폐잡음적궤리위심박당격병폐이산생적분기성잡음，기분류：①열이악성류와명양병이성심폐잡음。위심박당격폐내거대기강이산생。②심폐고격음。위중량기흉반불전폐불장수심박당격소산생。③심폐탄격음。위심박당격좌폐설협포성폐기종소산생。병이성심폐마찰음：①심폐마찰음，즉흉막—심포마찰음。②심폐제찰음。류심폐마찰음。위좌폐내측면소량다방포과성기흉수심장제압마찰소산생。악성병이성심폐잡음적은진특점위심첨—심전구향량、단촉、열이악성잡음，다위수축기，여심음관계불고정、전도엄범무정향성。압흉은진감약내지소실。무진전급마찰감。심흡기증강、심호기말병기소실。가변성강，동태관찰가단시내소실혹재현。모일특정체위잡음청초，변환체위잡음가소실。결론：건의심폐잡음응분류위생이성여병이성。
Objective To study pathogenesis and classification of cardiopulmonary murmur.Methods From 1963 to 1999,Author use method of auscultation and were clinical observed,8 cases of cardiopulmonary murmur and refer to the literary of historical data.Results Point out that the pathocardiopulmonary murmur producted mechanism,it was heart beating clashed pathopulmonary jet-pulmonary murmur.Classification:①Pleasant to the ear、musical froggy-singing cardiopulmonary murmur.It was producted due to heart beating compressed pulmonary macrocavity.It was jet-pathopulmonary murmur.②Cardiopulmonary knoking murmur.It was producted by moderate pneumothorax accompany a part of atelectasis.③Cardiopulmonary flicking murmur.It was producted by blisting emphysema in left pulmonary tongue lobe.And pathocardiopulmonary friction sound:①Cardiopulmonary friction sound,that is pleuroperecardial friction sound.②Cardiopulmonary clashofriction sound.It was similar cardiopulmonary friction sound.It was producted by heart beating compressed and grind pneumothorax,it was a little encysted and quite a few air bag on the inside surface of left lung.Auscultatory characteristic feature of pathocardio pulmonary musical murmur.It most a loud,pleasant to the ear,musical,systolic murmur,high-pitched and short,at the apex or precordium.It was transmitted to the wide spead,however,no definited direction.When pressed deeply the thoracic piece of stethoscope were auscultation.It was no accentuated sound.On the contrary,may be decreased or disapears suddenly.If murmur was loud,but there was not thrill and most no friction sensation.Auscultation of murmur,it was clearer when deep inspiration.When deep expiration end and discontinue,it was disappear.Murmur were variable great,it may be disappears suddenly or again appears as passed of time or change position of body.Conclusion It is suggested that cardiopulmonary murmur must be classify in pathologic and physiologic murmur.
