Comparison of stethoscope bell and diaphragm, and of stethoscope tube length, for clinical blood pressure measurement.
Comparison of stethoscope bell and diaphragm, and of stethoscope tube length, for clinical blood pressure measurement.
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DOI：
10.1097/mbp.0000000000000175
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发表时间：
2016-06
影响因子：
1.3
通讯作者：
Zheng D
中科院分区：
文献类型：
--
作者：
Liu C;Griffiths C;Murray A;Zheng D
本研究探讨了听诊器侧边和听诊器管长对听诊血压测量的影响。对32名健康参与者进行了研究。对于每个参与者，在两次重复会话中记录了四种不同听诊器特征组合(钟形或隔膜侧、标准或短管长度)的测量结果，并在不同的日期向一名经验丰富的听者播放了八段Korotkoff声音记录，以确定收缩和舒张压(SBP和DBP)。采用方差分析研究两次重复测量和两次不同日期血压测量的重复性，以及听诊器侧长和管长对测量的影响。SBP和DBP的重复次数之间以及重复测定之间没有显著的配对差异(除了使用短管和横隔膜的SBP的重复次数外，所有P值均为0.10)。关键结果是使用钟形器的舒张压低于使用隔膜的舒张压(0.66 mm Hg，P=0.007)，使用短管的收缩压显著高于标准长度的舒张压(0.77 mm Hg，P=0.008)。这项研究表明，听诊器的特性对临床血压测量只有很小的影响，尽管在统计学上有显著意义。虽然这有助于理解测量技术，并解决了已发表文献中的问题，但其影响并不具有临床意义。
This study investigated the effect of stethoscope side and tube length on auscultatory blood pressure (BP) measurement. Thirty-two healthy participants were studied. For each participant, four measurements with different combinations of stethoscope characteristics (bell or diaphragm side, standard or short tube length) were each recorded at two repeat sessions, and eight Korotkoff sound recordings were played twice on separate days to one experienced listener to determine the systolic and diastolic BPs (SBP and DBP). Analysis of variance was carried out to study the measurement repeatability between the two repeat sessions and between the two BP determinations on separate days, as well as the effects of stethoscope side and tube length. There was no significant paired difference between the repeat sessions and between the repeat determinations for both SBP and DBP (all P-values>0.10, except the repeat session for SBP using short tube and diaphragm). The key result was that there was a small but significantly higher DBP on using the bell in comparison with the diaphragm (0.66 mmHg, P=0.007), and a significantly higher SBP on using the short tube in comparison with the standard length (0.77 mmHg, P=0.008). This study shows that stethoscope characteristics have only a small, although statistically significant, influence on clinical BP measurement. Although this helps understand the measurement technique and resolves questions in the published literature, the influence is not clinically significant.