肠鸣音在胃肠外科临床应用中价值的再认识  

Re-recognition of the Value of Bowel Sound in Clinical Application of Gastrointestinal Surgery

作　　者：张鑫[1] 卫子然[1] 朱振新[1] 杨德君[1] 蔡清萍[1] ZHANG Xin;WEI Ziran;ZHU Zhenxin;YANG Dejun;CAI Qingping(Department of Gastrointestinal Surgery,Changzheng Hospital,Second Military Medical University,Shanghai 200003,China)

机构地区：[1]第二军医大学长征医院胃肠外科,上海200003

出　　处：《中国继续医学教育》2020年第26期129-132,共4页China Continuing Medical Education

基　　金：国家自然科学基金面上项目(81773049);上海市优秀青年专科医师培养资助计划;上海申康医院发展中心临床科技创新项目(SHDC12017126);海军军医大学教学研究与改革项目(JYC2017043)。

摘　　要：肠鸣音听诊是腹部体格检查中的一项重要内容,其在腹部外科及胃肠疾病诊治中的价值曾被广为认可并写入经典的医学专著。然而,由于肠鸣音具有个体差异大、随机性强等特点,在实际临床工作中,许多医生几乎不关注这一临床体征,有些医生甚至完全抛弃了听诊器。而且,对于肠鸣音听诊的临床意义,目前尚缺乏高级别的循证医学研究数据的支持,使得肠鸣音听诊的临床价值成为了学术界争论的焦点。基于此,文章拟从肠鸣音的临床意义和肠鸣音发生的病理生理学机制进行系统的文献回顾,对肠鸣音研究面临的挑战加以展望并进行深入探讨,以期进一步完善和推动肠鸣音在胃肠外科中的临床应用。Bowel sound auscultation is an important part of abdominal physical examination.Its value in abdominal surgery and gastrointestinal diseases has been widely recognized and written into classic medical works.However,because of the characteristics of bowel sounds,such as large individual differences and strong randomness,in the actual clinical work,many doctors pay little attention to this clinical sign,and some doctors even completely abandon the stethoscope.Moreover,for the clinical significance of bowel sound auscultation,there is still a lack of high-level evidence-based supporting data,which makes the clinical value of bowel sound auscultation become the focus of academic debate.Based on this,this paper reviews the clinical significance and the pathophysiological mechanism of the occurrence of bowel sounds,and looks forward to the challenges faced by the research of bowel sounds,so as to further improve and promote the clinical application of bowel sounds in gastrointestinal surgery.

关 键 词：肠鸣音 胃肠外科 人工智能 卫生装备 体格检查 临床教学 

分 类 号：R574[医药卫生—消化系统]