It can be compared with cardiac auscultation. According to the anatomical position, the heart sound is divided into the first heart sound and the second heart sound, etc. The respiratory sound can also be divided into four respiratory sounds according to the bronchial, bronchial alveoli, alveoli, and trachea.

Normal breathing sounds are the same as heart sounds, and the sounds are definitely rhythm, tone, volume, etc., which makes people feel comfortable and not abnormal.

If the respiratory sound is abnormal, just remember one thing, every clinical abnormality is closely related to anatomy. For example, in this patient, if there is pleural effusion, the normal gas exchange activity of the patient in the area where the lesion is located will be limited, and the alveolar respiratory sound at the location where the lesion is located will directly weaken or even disappear. It is not difficult to hear and judge this clinically.

In addition to auscultation, the lungs need to be treated with care. At this time, the clinical difficulties of this patient are exposed. Doctors’ lung percussion starts from the second intercostal space and avoids the heart and liver for percussion. Obese patients are difficult to even touch the ribs and intercostal spaces.

When the students were listening to percussion, Xin Yanjun took out the imaging results of the X-ray CT film and B-ultrasound that the patient had previously examined and looked at it again. When it was difficult for clinicians to directly witness the abnormality of the patient, they needed to use more modern medical equipment to help them.

Unfortunately, the examination of these auxiliary equipment cannot help doctors solve all clinical problems once and for all. Because the instrument will make mistakes. When placed in the patient who is suspected of pleural effusion, this error will lead to serious consequences.

For patients with pleural effusion, the first choice is not surgery. The cause does not involve surgery. If the cause is not involved, it is just an effusion.

It can be compared with patients with lower ascites.

The production and absorption of pleural effusion in normal people is in a dynamic balance. Like ascites, the stock is very small, with a maximum of more than ten milliliters. If the effusion exceeds the upper limit of tolerance that the human body can bear and affects the patient's breathing and other important vital signs, doctors must take measures similar to those of ascites, and rescue them first.

Thoracic puncture fluid discharge is different from surgery. It is an operation under blind vision. Blind vision depends entirely on pre-operative judgment rather than doing it while watching during surgery. Therefore, if the pre-operative judgment instrument makes mistakes, the consequences will be very serious.

For example, in clinical practice, in order to avoid error consequences, B-ultrasound or CT will be introduced again for guidance during surgery.

The problem is that CTs in pleural effusions can make mistakes. For example, encapsulated pleural effusions, CTs judge that the doctor can extract liquid by puncture, which seems to be correct. However, after a few shots, it shows that the clinical effect is not good and cannot be cured. In the end, you have to make up your mind to do surgical investigations to determine that it is not pleural effusions but teratomas. Teratomas are not bad. If it is lung hydatosis, those who cannot judge CTs and do not know will extract fluid, which is equivalent to hydatoma spreading.

The above extreme conditions can be referred to as rare diseases, which are less likely to occur in clinical practice, and the probability of doctors seeing them is low. If you encounter them, you can say that you have won the lottery. However, the following situations are common in clinical practice.
Chapter completed!