大实话!为什么我说心脏叩诊过时了 !

2016-05-13 雁方 医学界心血管频道

在求学阶段,医生都学过心脏浊音界叩诊,但在后来的临床诊断中,真正应用这项体格检查技术的医生却寥寥无几,甚至可以说没有。这项技术只在临床教学时才应用,并且某些专家认为此项检查很重要,但很多专家诊病从来不进行心脏叩诊。   学以致用!   一项不能在临床实践中得到很好应用的体格检查,我认为没必要再强调其重要性,作为了解内容即可,甚至可以摒弃。所以我说心脏浊音界叩诊过时了。

在求学阶段,医生都学过心脏浊音界叩诊,但在后来的临床诊断中,真正应用这项体格检查技术的医生却寥寥无几,甚至可以说没有。这项技术只在临床教学时才应用,并且某些专家认为此项检查很重要,但很多专家诊病从来不进行心脏叩诊。
 
学以致用!
 
一项不能在临床实践中得到很好应用的体格检查,我认为没必要再强调其重要性,作为了解内容即可,甚至可以摒弃。所以我说心脏浊音界叩诊过时了。
 
为什么被标榜为有重要作用的心脏叩诊没有医生去应用?
 
一:心脏浊音叩诊要求在安静的环境下进行,在安静的环境下叩诊结果才会准确。当前医院的环境就像集贸市场,那有安静可言。不信,你就到各大医院门诊、病房看一下就知道了。
 
二:心脏浊音界叩诊结果的判定由医生主观断定,没有客观的标准。一个医生叩诊的结果是心浊音界增大,另一个医生叩诊的结果可能正常。
 
三:心脏病急症发作时,心浊音界叩诊对诊断病情帮助不大,并且延误抢救时间。
 
四:目前方便快捷的心脏辅助检查足以替代心脏叩诊。心电图、床旁彩超、床旁胸片可以很快帮助医生对病情有很好的初歩判断。
 
由于以上种种原因,导致心内科医生在临床工作中很少应用心脏叩诊。既然心脏叩诊在临床中很少应用,我们对后来者就不要苦苦相逼。
 
心脏浊音界叩诊过时了,至少是不合时宜了。

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#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=86629, encodeId=812686629f7, content=非常同意!完全纸上谈兵!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58c51689097, createdName=kanardo, createdTime=Thu May 19 20:13:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85967, encodeId=06b18596ec7, content=虽然主观,但是也可以进行一些比较严重的快速的初步判断, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Mon May 16 08:52:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85849, encodeId=ba118584904, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85850, encodeId=5d7c8585075, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85822, encodeId=f219858227c, content=其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sun May 15 08:17:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85681, encodeId=e97885681d7, content=说的有道理,解放生产力, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Fri May 13 23:54:00 CST 2016, time=2016-05-13, status=1, ipAttribution=)]
    2016-05-19 kanardo

    非常同意!完全纸上谈兵!

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=86629, encodeId=812686629f7, content=非常同意!完全纸上谈兵!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58c51689097, createdName=kanardo, createdTime=Thu May 19 20:13:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85967, encodeId=06b18596ec7, content=虽然主观,但是也可以进行一些比较严重的快速的初步判断, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Mon May 16 08:52:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85849, encodeId=ba118584904, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85850, encodeId=5d7c8585075, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85822, encodeId=f219858227c, content=其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sun May 15 08:17:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85681, encodeId=e97885681d7, content=说的有道理,解放生产力, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Fri May 13 23:54:00 CST 2016, time=2016-05-13, status=1, ipAttribution=)]
    2016-05-16 QQ76174b26

    虽然主观,但是也可以进行一些比较严重的快速的初步判断

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=86629, encodeId=812686629f7, content=非常同意!完全纸上谈兵!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58c51689097, createdName=kanardo, createdTime=Thu May 19 20:13:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85967, encodeId=06b18596ec7, content=虽然主观,但是也可以进行一些比较严重的快速的初步判断, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Mon May 16 08:52:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85849, encodeId=ba118584904, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85850, encodeId=5d7c8585075, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85822, encodeId=f219858227c, content=其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sun May 15 08:17:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85681, encodeId=e97885681d7, content=说的有道理,解放生产力, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Fri May 13 23:54:00 CST 2016, time=2016-05-13, status=1, ipAttribution=)]
    2016-05-15 wxsessionc9c1d4ae

    虽然不实用,但是还不是得应付各种考试题目

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=86629, encodeId=812686629f7, content=非常同意!完全纸上谈兵!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58c51689097, createdName=kanardo, createdTime=Thu May 19 20:13:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85967, encodeId=06b18596ec7, content=虽然主观,但是也可以进行一些比较严重的快速的初步判断, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Mon May 16 08:52:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85849, encodeId=ba118584904, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85850, encodeId=5d7c8585075, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85822, encodeId=f219858227c, content=其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sun May 15 08:17:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85681, encodeId=e97885681d7, content=说的有道理,解放生产力, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Fri May 13 23:54:00 CST 2016, time=2016-05-13, status=1, ipAttribution=)]
    2016-05-15 wxsessionc9c1d4ae

    虽然不实用,但是还不是得应付各种考试题目

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=86629, encodeId=812686629f7, content=非常同意!完全纸上谈兵!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58c51689097, createdName=kanardo, createdTime=Thu May 19 20:13:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85967, encodeId=06b18596ec7, content=虽然主观,但是也可以进行一些比较严重的快速的初步判断, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Mon May 16 08:52:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85849, encodeId=ba118584904, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85850, encodeId=5d7c8585075, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85822, encodeId=f219858227c, content=其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sun May 15 08:17:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85681, encodeId=e97885681d7, content=说的有道理,解放生产力, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Fri May 13 23:54:00 CST 2016, time=2016-05-13, status=1, ipAttribution=)]
    2016-05-15 medcardio

    其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=86629, encodeId=812686629f7, content=非常同意!完全纸上谈兵!, beContent=null, objectType=article, channel=null, level=null, likeNumber=120, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=58c51689097, createdName=kanardo, createdTime=Thu May 19 20:13:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85967, encodeId=06b18596ec7, content=虽然主观,但是也可以进行一些比较严重的快速的初步判断, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Mon May 16 08:52:00 CST 2016, time=2016-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85849, encodeId=ba118584904, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85850, encodeId=5d7c8585075, content=虽然不实用,但是还不是得应付各种考试题目, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=44e31716701, createdName=wxsessionc9c1d4ae, createdTime=Sun May 15 10:58:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85822, encodeId=f219858227c, content=其实新的技术出现很多过去的这种诊断方式都会被淘汰这是很正常的, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sun May 15 08:17:00 CST 2016, time=2016-05-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=85681, encodeId=e97885681d7, content=说的有道理,解放生产力, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=172d1721528, createdName=QQ6709219e, createdTime=Fri May 13 23:54:00 CST 2016, time=2016-05-13, status=1, ipAttribution=)]
    2016-05-13 QQ6709219e

    说的有道理,解放生产力

    0