高空飞行中抗噪电子听诊器与普通听诊器心脏听诊效果分析

Effect comparison of cardiac auscultation between ordinary stethoscopes and antinoise electronic stethoscopes during a high-altitude flight

目的评估抗噪电子听诊器和传统普通听诊器在运-8C卫生飞机高空平飞阶段心脏听诊的效果。方法预先将正规医学网站上下载正常心音和主动脉关闭不全的异常心音存储于平板电脑中,在运-8C卫生飞机进入高空平飞阶段,播放正常心音和异常心音,由39名临床医师依次选取传统普通听诊器和抗噪电子听诊器进行听诊,依据医师听诊结果来评估听诊效果(听诊正确、听诊错误或未听到)。使用χ~2检验完成对所得数据的统计分析。结果在地面阶段,传统普通听诊器及抗噪电子听诊器听诊正常心音或异常心音的正确率均为100.00%;在运-8C卫生飞机平飞阶段,抗噪电子听诊器听诊正常心音和异常心音的正确率分别为71.79%、61.54%,普通听诊器听诊正常心音和异常心音的正确率分别为2.56%、0,差异具有统计学意义(P<0.01)。结论抗噪电子听诊器心脏听诊正确率显著高于传统普通听诊器,为医护人员在空运后送过程中评估伤员病情提供更多依据。

Objective To evaluate the different effects of ordinary stethoscopes and antinoise electronic stethoscopes on cardiac auscultation when a Y-8C transporter, a medical evacuation aircraft, is flying at high altitude. Methods Normal and abnormal heart sounds caused by aortic insufficiency were downloaded from authorized medical websites in advance and stored in a tablet PC. 39 clinicians auscultated those heart sounds using traditional ordinary stethoscopes and antinoise electronic stethoscopes by turns on the ground or during a high-altitude flight （in a Y-8C transporter）. According to auscultatory results （correct auscultation, incorrect auscultation and missed auscultation） of the doctors, the effects of cardiac auscultation were evaluated before the obtained data was analyzed by Chi-square test. Results On the ground, the accuracy rates of cardiac auscultation by conventional stethoscopes and antinoise electronic stethoscopes were both 100.00%. When the Y-8C transporter was in the level flight phase, the cardiac auscultation by antinoise electronic stethoscopes was significantly;more accurate than that of traditional ordinary stethoscopes. The accuracy of the former was 71.79% for normal heart sounds, and 61.54% for abnormal heart sounds, compared to 2.56% and 0 of the latter. The difference was of statistical significance（P〈0.01）. Conclusion The cardiac auscultation accuracy of antinoise electronic stethoscopes is significantly superior to that of traditional ordinary stethoscopes. Medical personnel can use antinoise electronic stethoscopes to assess the condition of the injured during aeromedical evacuation