常用医学英语双语对话

2012-12-11 MedSci MedSci原创

P: Good morning, doctor.D: Good morning, please sit down. What seems to be the matter?P: I think I might have caught a cold.D: How long have you been sick?P: For two days.D: What symptoms do you have?

P: Good morning, doctor.
D: Good morning, please sit down. What seems to be the matter?
P: I think I might have caught a cold.
D: How long have you been sick?
P: For two days.
D: What symptoms do you have?
P: I have a runny nose and I ache all over.
D: What was the discharge like?
P: Watery.
D: Is it the same today?
P: No, it is yellow and thicker today.
D: Do you have a fever?
P: I haven't taken my temperature yet, but I feel feverish.
D: Let me take your temperature. It will take 10 minutes. ... Yes, you do have a fever. Were you exposed to cold temperatures?
P: Yes, the day before yesterday when I went to work, the weather was warm so I didn't wear extra clothes. In the evening the temperature dropped down rapidly. On the way home I felt very cold. After arriving home I began to sneeze. When I got out of bed the next morning my nose was stuffy and running.
D: Do you have a cough?
P: I just started coughing today.
D: Do you have phlegm?
P: Yes, but not much.
D: What color is it?
P: Pale yellow.
D: Is it easy to cough up?
P: Not very. I have to use effort to cough it up. The phlegm is a little sticky.
D: Have you been sweating?
P: I sweated a little after taking some medicine for fever last night.
D: Are you thirsty?
P: Yes, I feel like drinking cool water.
D: Do you have a sore throat?
P: Yes, I do.
D: I want to look at your throat. Please open your mouth.
D: Do you feel any other discomfort?
P: I feel sore everywhere and I feel very tired too.
D: Please stick out your tongue and let me have a look. You have a red tongue with thin and yellow coating, which indicates wind and heat in the superficial area. Please put your hand here and let me feel your pulse. ... The pulse is superficial and rapid.
P: What does a superficial and rapid pulse mean?
D: A superficial pulse means the attack of pathogens to the exterior layer of the body which is called exterior syndrome in Traditional Chinese medicine, while a rapid pulse indicates heat.
P: What is the diagnosis of Chinese medicine for me?
D: It is a common cold. According to the symptoms, the manifestation of the tongue and pulse, you have got a common wind-heat type cold.
P: Can you explain it more in detail?
D: Pathogenic wind heat often attacks the body through the nose and mouth. The lung is involved first. Pathogenic wind of yang nature is characterized by upward and outward dispersion. When a fight goes on between the pathogenic wind heat and the body resistance, fever, slight aversion to wind and sweating result. When the pathogenic wind heat attacks the head, symptoms like pain and distending sensation occur in head.
P: That's interesting.
D: When the lung fails to disperse and descend, a ten-year-old patient has a cough with yellow, thick sputum. When the pathogenic wind heat stifles the air passage, the patient experiencing a congested sore throat with thirst. Thin, white or yellowish tongue coating, and superficial rapid pulse are the signs showing the lung and the defensive system being attacked by the pathogenic wind heat.
P: I see. I'd like to be treated with Traditional Chinese medicine. That is why I came here. What kind of treatment will you give to me?
D: I suggest the prescription Yin Qiao San for you. It is a typical formula for treating wind heat type of common cold. We may modify it by adding some more herbs to relieve the sore throat and the runny nose. I will give you four doses. Every day take one. Every dose brings to a boil and drain off the liquid. Add cold water and bring it to a boil the second time. Drink the liquid from both times. Do you understand?
P: Yes, I do.
D: Also, I'll now give you acupuncture treatment on the points of the lung, large intestine and bladder meridians, using the reducing method. This will be very effective in relieving your headache and runny nose.
P: Will it be painful?
D: No, just like a mosquito bite. After that we may apply cupping to your upper back.
( After the treatment)
P: Oh, I feel much better after the acupuncture treatment. My headache has gone and the sore throat has lessened. Thank you.
D: After returning home be careful to rest and drink more hot water. This is your prescription. Go to the Chinese medicine pharmacy and fill your prescription.
P: Ok. Thank you very much, doctor.
D: You are welcome.
参考译文
病人:早上好,医生。
医生:早上好。请坐。您那里不舒服?
病人:我想我感冒了。
医生:您病了多久了?
病人:2天。
医生:您有什么症状吗?
病人:我流鼻涕,而且觉得全身疼痛。
医生:鼻涕怎么样的?
病人:水样的。
医生:今天也一样吗?
病人:不,今天是黄色的,而且变稠了。
医生:有没有发热啊?
病人:我没有测过体温,但是我自己觉得发烧了。
医生:让我先帮您测体温。大概需要十分钟。 ... ... 是的,您确实是发热。您怕冷吗?
病人:是的。前天我去上班的时候天气还挺暖和的,当时我就没有多穿衣服。但晚上温度下降得很快,当我回家的时候我觉得很冷。回家后,我就开始打喷嚏了。第二天早上起床的时候我就觉得鼻塞流涕了。
医生:您有没有咳嗽啊?
病人:今天刚开始。
医生:您有痰吗?
病人:有,但不多。
医生:什么颜色的?
病人:浅黄色的。
医生:容易咯出来吗?
病人:不是太容易。我需要用力才能咯出。这痰有点粘稠。
医生:您有出汗吗?
病人:昨晚吃了退烧药后出了一点。
医生:觉得口渴吗?
病人:是的,我比较想喝冷水。
病人:是的,
医生:我想要看看您的喉咙,请张开口。
医生:您还觉得哪里不舒服吗?
病人:我觉得全身疼痛,而且觉得非常累。
医生:请伸出舌头让我看看。他的是舌红苔薄黄,提示着风热袭表。
医生:请把手放到这里,我给您把把脉。脉是浮数的。
病人:脉浮数意味着什么?
医生:浮脉代表着邪袭体表,在中医里这也叫表证,而数脉提示的是有热。
病人:中医诊断是什么?
医生:根据症状、舌脉的表现,这属于感冒,风热型。
病人:你能详细解释一下吗?
医生:风热之邪常会通过口鼻侵犯机体,而肺先受之。属于阳的风邪就具有向上、向外升散的特性。当风热之邪与机体正气相互搏斗,就会导致发热、恶风以及汗出。当风热之邪侵袭头部,就会有头痛、头胀等症状的出现。
病人:听起来很有趣。
医生:如肺失宣降,就会出现咳嗽,咯黄稠痰。当风热之邪使气道失于通畅,就会出现咽喉充血,疼痛以及口渴。苔薄白或薄黄,浮数脉都是肺卫被风热之邪侵袭的表现。
病人:我想以中药治疗。这就是我来这的原因。你们将会予我什么治疗呢?
医生:我建议用银翘散。那是一条典型的用以治疗风热型感冒的方。我们可以在此基础上加一些用于缓解咽痛和流涕症状的草药。我将会给您开四剂药。每天一剂。猛火煎药,然后倒出药汁。然后再加冷水复煎一次。把两次煮的药都喝完,明白吗?
病人:知道了。
医生:我们能否给他用针灸治疗来缓解症状?我会用泻法在你的肺经、大肠经和膀胱经上的穴位上用针。这对于缓解你头痛和流涕的症状是很有效的。
病人:针灸会很痛吗?
医生:不会,就像蚊子咬,然后我们可以在他上背部拔火罐。
治疗后
病人:我觉得治疗后舒服多了。我的头不痛了,而且咽痛也缓解很多了,感觉好多了。谢谢。
医生:回家后要注意休息,还要喝多点热水。这是您的处方,您可以到中药店抓药。
病人:好的,谢谢,再见。
D: Good morning, what seems to be the problem today, Mr. Chen?
P: Well, I've had nocturia for six months and I started losing weight four months ago.
D: Any other problems? Have you noticed any changes in your urine?
P: Yes, it's darker, reddish. I wonder if it could be blood.
D: Have you noticed anything else?
P: Yes. I've felt sick several times in the morning and I've noticed my legs are swollen after work in the evening. Also, I've felt really groggy for some weeks now. I don't seem to enjoy my food any more and I've lost weight.
D: How much?
P: About 6Kg.
D: How long have you had this trouble?
P: About 4 months really.
D: Have you ever had trouble with your urine before?
P: Yes. Two years ago I had a burning sensation when I passed water. The doctor said that I had high blood pressure as well and he put me on tablets and it cleared up.
D: Well, I'd like to examine you. Please come to the examination room, remove your clothes except your underpants, and lie on the table.
(After examination)
D: You can get dressed now ... well, it looks like you have some reduced kidney function. I want you to take some blood tests, X-rays and kidney function tests. I'd like you to collect your urine for 24 hours. The nurse will tell you exactly how to do it. Then we'll ask you to come in for an ultrasound examination of the kidneys. This is a very simple procedure to make sure there is no obstruction.
P: Can you tell me exactly what is wrong with my kidneys?
D: Well, the tests show that you are in a condition called chronic glomerulonephritis, which has damaged the kidneys.
P: Is the chronic glomerulonephritis severe? Are there any good treatments to repair the kidney damage?
D: Yes, of course. You'd better stay in the hospital for treatments, and observation. We'll have to insert a tube into your abdomen to flash out toxic substances in the blood stream.
P: How long will I have to stay in hospital? Will I have to stop working?
D: For about 3-4 weeks. Just remind me. What's your job?
P: I'm a teacher.
D: Well, I should advise you to have a 2-month rest.
P: Thank you doctor.
D: Not at all.
参考译文
医生:早上好,陈先生,你哪里不舒服?
病人:我夜尿多(遗尿)六个月了,而且我四个月前体重开始下降。
医生:还有别的不舒服吗?您有没有留意过您小便跟以前有什么不同吗?
病人:是的,它是暗红色的。我都怀疑那是不是血。
医生:您还发现别的什么吗?
病人:有啊,我早上和晚上工作后都有几回觉得恶心。我还留意到我的腿肿胀了。我近几周来总觉得头昏眼花,而且也没什么胃口,体重也下降了。
医生:降了多少?
病人:大约6公斤。
医生:像这样子多久了?
病人: 大概4个月吧。
医生:您以前小便也有过异常吗?
病人:是的,两年前我曾在小便的时候有尿道的灼热感。医生检查后也说我有高血压,并给了我一些药片吃,吃了之后就好了。
医生:好的,我想给您检查一下。请您脱下衣服,只剩下内衣,然后躺在那检查床上,先用毛毯盖上,我等下就来。
(检查后)
医生:您现在可以穿好衣服了。我想您的问题在于您的肾没有正常的运作。我希望您能够进行血液、X线以及肾功能方面的检查。同时,我也需要您收集24小时的小便。具体怎样做护士会告诉您。然后,我们会在再让您进行肾的超声检查。然后我们就可以根据这一个非常简单的程序去判断有没有梗阻情况的存在。
病人:您能确切地告诉我我的肾有什么问题吗?
医生:检验结果显示您得了慢性肾小球肾炎,而那病是您的肾功能受到损害。
病人:那慢性肾小球肾炎严重吗?有针对肾功能损害的好的治疗方法吗?
医生:呃,有的。我想你需要住院作治疗了,我们将会一直跟踪你的病情。我们要在你的腹部放个管子,通过液体在其中的流通达到清洗血液的作用,同时也把血液中的毒素排出。
病人:那我大概需要住院多长时间?那我是不是需要停止工作呢?
医生:大概3到4周。您提醒我了,您是从事什么职业的?
病人:我是一名教师。
医生:那样的话我建议您休息2个月。
病人:谢谢您,医生。
医生:不用客气。
D: What's the matter with you?
P: I have been feeling thirsty recently, and I am always tired.
D: How about your urination?
P: I pass more urine than I used to.
D: How many times a day?
P: About eight times.
D: How about your appetite?
P: My appetite has been good, but I still feel I am losing weight.
D: Any other symptoms?
P: I can't concentrate on anything for long, and I always feel weak. I have said that, I guess. Sometimes I also feel dizzy.
D: How old are you?
P: I'm 45 this year.
D: Sir, do you have anyone in your family who has diabetes?
P: Yes, my father has had diabetes for nearly 15 years. What do you mean, doctor? Do you mean I have got diabetes?
D: According to your symptoms and your father's history, there is a strong possibility that you have got diabetes, as the disease runs in families. Of course, we need to do some checks. First please go to the Laboratory Department and examine your urine and blood sugar. Come back to me with the report.
(Later with the results of the examination)
D: The examination shows an elevation of blood sugar and you have sugar in your urine. You have got diabetes.
P: Is it serious? What's a normal blood sugar level?
D: It is <130mg%, Generally it is 80—120mg%. Diabetes is a disease due to the poor function of the pancreas, which brings about metabolic disorder of sugar, fat and protein. It's a chronic disease. At the time being there is still no way to cure it. But as I said your case is not serious now. If you pay attention to treatment your diet and you will get better gradually.
P: What else should I pay attention to? Is there a diet for diabetes?
D: Having your urine tested regularly to see how your disease is going is very important. On the other hand, you should try to omit sugar from the diet. This includes candy, cake, ice-cream, etc. High starch foods such as bread, potato, rice, etc should be limited, too.
P: Thank you very much, doctor. Godbye.
D: Goodbye.
参考译文
医生:您哪里不舒服?
病人:我最近觉得口渴,而且总是觉得很累。
医生:小便怎样?
病人:小便比以前更多了。
医生:一天几次?
病人:大概8次。
医生:胃口怎样?
病人:胃口很好,但我觉得体重反而轻了。
医生:还有别的症状吗?
病人:我不能长时间集中注意力干活,而且总是觉得疲惫。我想这我刚才都说了,有时我还会头晕。
医生:您多大岁数了?
病人: 45岁。
医生:那您家里有没有人是得糖尿病的?
病人:有,我父亲患有糖尿病接近15年了。您这是什么意思啊,是指我患上糖尿病吗?
医生:根据您的症状和您父亲的病史,也因为这种疾病有家族史,所以您得糖尿病的可能性很大。当然,我们需要做些检查。首先,请到检验科检验一下尿液和血糖。有检查结果后回来找我。
(检验结果出来后)
病人:我的情况如何?
医生:检验结果显示您血糖升高,尿中也有尿糖。你得了糖尿病。
病人:严重吗?那正常的空腹血糖水平是多少?
医生:那是<130mg%, 经常是在80—120mg%。糖尿病是由于胰腺功能的失调,引起糖、脂肪和蛋白质的代谢紊乱。那是一种慢性病,具有多尿、多饮、多食的症状。在现阶段还没有方法能治愈。但就像我说的那样,您现在的情况并非很严重。如果您注意治疗和饮食,您会慢慢好起来的。
病人:我还有没有别的什么需要注意的?应该采用什么样的饮食呢?
医生:定期进行尿液检测以观察疾病的进程是重要的。另外,你必须把饮食中的糖都去掉,这包括糖果、蛋糕、雪糕等,而且也应该限制高淀粉的食物,例如面包、土豆、米饭等。
病人:非常谢谢您,医生。再见。
医生:再见。
D: Good morning! Please have a seat. I just need to get some information from you. Could I have your name please?
P: My name is Wang Ping.
D: What kind of work do you do?
P: I am a taxi driver.
D: That's fine. Now, tell me what's bothering you.
P: Well, I've got a dreadful stomachache and I've lost my appetite.
D: How long have you been feeling this way?
P: For about one year. First it was just a slight a pain, but it's got much worse recently.
D: Could you tell me exactly where the pain is?
P: Yes, it's right here. This is the worst spot.
D: Is it a fixed pain?
P: Yes, it doesn't seem to move.
D: Does the pain ever spread to any other area?
P: No.
D: What sort of pain is it? Sharp? Dull?
P: It's a distended feeling, and it gets worse if I eat anything cold.
D: Do you ever fell it when you're hungry?
P: Yes, often, but it gets better if I eat something.
D: If you rub or massage it, does it help?
P: Yes, it does.
D: Do your hands and feet often feel cold?
P: Yes, often ... and very cold too.
D: Is the pain constant, or does it come and go?
P: It comes and goes.
D: And how long does each attack last for?
P: Oh ... about two hours.
D: Do you feel the most painful in the daytime?
P: Yes, I think so. Usually about three hours after meals. But sometimes it wakes me up at night.
D: Are you aware of anything that brings the stomachache on?
P: It's hard to tell. First, I think it comes after I eat raw and cold food. Recently I've felt it when I'm busy at work or I'm in a bad mood.
D: Generally, how's your appetite?
P: Not so good. I always feel bloated. So I don't feel like eating anything. What's more, no matter what I eat, it's tasteless.
D: Do you have any burping or acid regurgitation?
P: Yes, I burp a lot.
D: Have you been very thirsty lately?
P: No, I'm not interested in drinking anything.
D: Do you prefer hot or cold drinks?
P: Oh, definitely something hot.
D: Have you got any unusual tastes in your mouth?
P: Yes, a sour taste, and I get acid regurgitation, too.
D: What are your bowel movements like?
P: They're soft and sometimes I have diarrhea.
D: Any problems with passing water?
P: No, I don't think so.
D: Have you lost any weight lately?
P: No, my weight is the same as it was.
D: Have you ever had any other problems?
P: I'd always been in good health and never had any serious problems, not even a cold.
D: Do you smoke or drink or have any other habits that might affect your health?
P: I don't smoke, but drink a little.
D: Have you ever had an X-ray or ultrasound B for this problem?
P: Yes, last year I had an X-ray and the doctor said I had a duodenal ulcer.
D: Have you ever had any treatment before this?
P: Yes, I've taken lost of tablets, but they haven't had much effect. So this time I'd like to try some Chinese herbs.
D: All right. Now let me look at your tongue, and then take your pulse. Mm ... the tongue is pale and a dull purple color. The coating is thin and white. Your pulse is deep, slow and uneven. According to the theory of Traditional Chinese Medicine, the stomachache you've got is caused by deficient cold affecting the Spleen and Stomach. The treatment principle is to warm the center and dispel the cold. I'll write a prescription for you ... .Here you are.
P: Thank you. I'll go and get the prescription filled right away.
D: Come to see me again after you have taken the medicine.
P: Yes, I will. Goodbye!
D: Goodbye.
参考译文
医生:早上好。请坐。我想先了解一些情况。请问您叫什么名字?
病人:我叫王萍。
医生:您从事什么工作?
病人:我是一名出租车司机。
医生:哦,那很好。那我有什么可以帮您的?
病人:我的胃痛的很厉害,胃口都没有了。
医生:像这样子多久了?
病人:大约一年了。开始的时候只是一点痛,但是最近痛得厉害多了。
医生:能告诉我具体哪里痛吗?
病人:可以,就是这里。这里是最痛的。
医生:痛处痛定吗?
病人:是的,它不是游走性的。
医生:疼痛有没有向别处蔓延呢?
病人:没有。
医生:请告诉我关于胃痛更多的资料。那是什么样的疼痛呢?
病人:那是一种胀感,而且进食冷食后会加重。
医生:什么东西会加重疼痛呢?您饿的时候有疼痛吗?
病人:有的,经常。但我进食后会有所改善。
医生:如果您按摩肚子,痛会缓解一些吗?
病人:会的。
医生:您的手脚经常会觉得冷吗?
病人:是的,经常。而且是很冷。
医生:疼痛是持续性的还是间歇性的?
病人:是间歇性的。
医生:每次发作大概持续多久?
病人:大约2个小时。
医生:白天疼痛得最厉害吗?
病人:痛通常是在餐后3后小时。有时会在晚上痛醒。
医生:您有没有注意到什么东西会诱发您胃痛吗?
病人:这很难说。我想吃了生冷的东西后就会痛。最近有几次也是因为我工作很忙或是心情不好而发作。
医生:您的胃口如何?
病人:不是很好。我总是觉得腹胀,所以不是很想吃东西。再者,无论我吃什么,都觉得淡而无味。
医生:有没有打嗝或是泛酸?
病人:有,我经常会打嗝。
医生:近来觉得口渴吗?
病人:不,我不想喝什么东西。
医生:那您是更喜欢喝热的还是冷的东西呢?
病人:应该是热点的。
医生:口中有什么味道吗?
病人:苦味,而且我也会泛酸。
医生:您的大便怎样?
病人:软的,有时还会腹泻。
医生:小便有问题吗?
病人:我想没有。
医生:最近体重有减轻吗?
病人:不,我跟以前一样重。
医生:您以前还有别的问题吗?
病人:我一向健康状况良好,从没得过什么大病,甚至感冒也没有。
医生:您平时吸烟或喝酒的吗?或者还有别的什么会影响健康的习惯吗?
病人:我不吸烟,但是会喝一点点酒。
医生:对于这个病您有没有做过X线或B超检查?
病人:有,去年我做过X线检查,医生说我得的是十二指肠溃疡。
医生:那在这之前有没有治疗过呢?
病人:有,我吃过很多的药,但是没什么用。所以这次我想试试中草药。
医生:好的。让我看看您的舌头。然后给您把把脉。嗯,舌紫淡暗,苔薄白,脉沉缓结。根据中医理论,您这种胃痛属于脾胃虚寒证。治疗原则是温中袪寒,我会写张处方给您。 ... 给您。
病人:好的,我马上就去抓药。
医生:吃完这些药下次再来复诊。
病人:是的,再见!
医生:再见。
{nextpage}
D: Good morning. What's the trouble?
P: I've been getting terrible headaches recently.
D: Is there anything else?
P: Yes. Sometimes I feel a bit nauseous. But that's it.
D: When did the headache exactly begin?
P: About two weeks ago. I've had slight headache on and off for the last few years, but none has been as bad as recently.
D: Have you ever visited a doctor or taken any medicine for it?
P: Ten years ago I went to the local hospital for a check-up, they told me that I had hypertension. Five years ago I was diagnosed with coronary heart disease and stayed in hospital for about one year, during which I also tried some TCM herbs. Since then things seem alright. However, two weeks ago I had a urinalysis taken and the test for proteinuria was positive.
D: Have you ever had any other diseases? For example, any renal diseases?
P: No. Nothing else.
D: What kind of medication have you had in the past?
P: I took capoten regularly and Nitroglycerin occasionally. They used to be helpful, but they don't work any more. According to the advice of the doctor, I added other antihypertension drugs, but it doesn't seem ... Well, anyway they don't work.
D: What about your blood pressure?
P: It used to be around 150/95 mmHg. But recently it has gone up to about 200/120 mmHg.
D: Have you taken any other tests recently?
P: Yes. Many, like urinalysis, blood tests, chest X-ray, electric cardiogram examination, ultrasonic cardiogram and even a CT. I've brought all the reports with me. Here you are.
D: Let me have a look. Yes. There is something wrong with your kidneys and the renal function is deteriorating, though not seriously, according to the results of the urinalysis and the blood test. But nothing abnormal was found on the CT of your kidneys. Let me give you a physical examination ... .Well, there is nothing unusual. But I think we need to do further examination, otherwise, without definite diagnosis your renal function it may continue to deteriorate.
P: Oh, is that serious?
D: No. It's not, but we can't resolve it if real cause is not found.
P: What kind of examination should I take?
D: I like you to have a renal angiography by interventional Radiology so as to examine the renal artery, because according to the data available, I think that your hypertension is caused by renal artery stenosis, which usually results in renovascular hypertension.
P: You mean I need an operation?
D: No, not exactly. Interventional Radiology is not surgery after all.
P: Is it safe?
D: Yes. It is a minimal traumatic method.
P: Isn't there any other alternative, like MRI?
D: Sorry, I'm afraid not. Up to now, interventional Radiology is considered to be the top standard for vascular examination, especially arterial examination. Besides, subsequent therapy may be explored during the operation if the stenosis of renal artery is confirmed.
P: What kind of therapy?
D: Once the diagnosis stenosis of renal artery is confirmed usually doctors perform a PTRA or percutaneous transluminal renal angiography. They'll plant a metal stent as part of the procedure. PTRA is simple but effective and so is considered the preferred therapy for secondary hypertension caused by renal artery stenosis.
P: Will I have to stay in hospital? I'd really prefer not to.
D: I suggest you stay in the hospital for at least a week. We'll need to confirm your condition just before the operation. Will that work for you?
P: Ok, Let's get it over before holiday.
D: Very well. We'll contact you soon. Take care and don't worry about the operation.
P: Thanks a lot. Goodbye.
D: You are welcome.
参考译文
医生:早上好。您哪里不舒服?
病人:我最近头痛得很厉害。
医生:还有别的不舒服吗?
病人:有时我还会觉得有点恶心。但就只有这些了。
医生:您头痛确切是从什么时候开始的呢?
病人:大概两周前。在过去的几年里我反复有轻微的头痛,但不会象最近痛得这么厉害。
医生:那您有没有看过医生或者吃过什么药呢?
病人:十年前我在当地医院检查,他们能告诉我我有高血压病。五年前我被诊断为冠心病,并因此住了大概一年院,在那期间我也试过中药。之后病情一直比较稳定。然而两周前我做了个尿分析,提示我的尿蛋白是阳性。
医生:您既往还有没有别的什么病?例如:肾脏方面的疾病呢?
病人:没有。
医生:您过去接受过什么治疗?
病人:我定期服用卡托普利,并偶尔吃硝酸甘油。它们以前都挺管用的,但现在不再起作用了。按照医生的建议,我又加了些降压药,但好像 ... ... 总之,作用都不大。
医生:那您血压控制得怎样?
病人:以前大概在150/95 mmHg,但最近突然升高,都差不多200/120mmHg了。
医生:您最近还进行了别的什么检查吗?
病人:是的,我最近做了很多检查,象尿分析、血分析、胸部X线、心电图、心脏超声检查,甚至CT。看,我都把所有的检查报告都带来了。
医生:让我看看。是的,从尿分析和血分析结果看来,您的肾有点问题,虽然不是很严重,可是肾功能正在衰退。但腹部CT未提示您的肾脏有异常。让我给您做个体格检查。嗯,没发现什么异常的。但我想您需要进一步的检查,否则,如果没有确切的诊断,您的肾功能会持续恶化。
病人:哦,那严重吗?
医生:不,但是如果真正原因没找到的话我们就不能对症下药了。
病人:我需要哪方面的检查呢?
医生:我建议您做一个肾血管造影,那样可以检查一下肾动脉。因为从现有的资料看来,我估计您的高血压是由肾动脉狭窄引起,而那常会引起肾性高血压。
病人:您是说我需要手术?
医生:不,毕竟放射介入治疗不算手术。
病人:安全吗?
医生:安全,它只是一种微创的检查方式。
病人:有没有别的什么检查方法可以代替的呢,例如MRI?
医生:很抱歉,恐怕没有了。到现在为止,放射介入被认为是血管方面检查的金标准,尤其是在动脉方面的检查。而且,如果肾动脉狭窄被证实的话,在检查中我们还会作出相应的治疗。
病人:那我需要住院吗?我可是很害怕住院啊。
医生:我建议您至少住院一周。我们需要在手术之前对您身体状况作出评估。你意下如何?
病人:好的,让我们在假期之前把这解决了。
医生:很好,我们很快会跟您联系。不用担心手术的,再见。
病人:谢谢,再见。
医生:不用谢。
P: Hello, doctor.
D: Hello, come in please! How are you feeling today?
P: Not great. I was just playing with my classmates, and all of a sudden I fell down. My right elbow hurts and my hand is bleeding. It happened really suddenly. I'm still in shock. Do you think I'll be Ok?
D: Let me have a look at your arm. Is it still painful? When did it happen?
P: Yes, it is. I hurt it about half an hour ago.
D: Would you please roll up your sleaves. ... That's fine. That's it. Sit traight. ... Now put your arms on your hips. ... fine. ... Now rest your arm on mine, that's right. I just want to feel under your arm ... Good. Now the other one. ... Now would you please lie down? Let me put this pillow under your right shoulder. ... Now put your right arm over your head. Fine. ... Do the same with the left. ... Good ... Get up please.
P: Yes.
D: Well, the radial pulse is present, and the sensation was intact. Shake my hand as hard as you can ... ... Oh! The strength is slightly diminished. I think we'd better do an X-ray.
P: Can we do that here?
D: No, the nurse will take you to the X-ray department. I'll be there in ten minutes.
(Later with the result of the examination)
P: Here is the X-ray result. Is it serious?
D: From the picture, you have a supracondylar fracture of the transcondylar type. It's not serious but it won't get better of its own accord. I think you'll have an operation.
P: But I have to go to school. I'll have a final exam in a month. Doctor, please help me!
D: Don't worry. You'll only be in for ten days or so and once the operation is over, you'll feel much better. Shall I put you on the waiting list?
P: All right.
D: I'll take you to the admissions office and make the necessary arrangements. Well, before that let's talk for just a few minutes about your condition. I've already written the orders to watch you carefully for the first 48 hours, and the nurse should report to me if the hand becomes painful, cold, pale, dusky, or swollen.
Nurse, please give me a suture set.
P: Are you going to sew up the wound on my hand?
D: Yes, just three stitches, I think. It won't be very painful, I'll fix you right up ... Okay, it is done. That wasn't so bad, was it?
P: No, not very.
D: Have you had a tetanus shot recently?
P: No. Do I need one?
D: Yes, Tetanus is a type of toxemia. That toxin diffuses throughout the tissues and involves the neuromuscles end-organs, causing spasm. Masseter muscle spasms are one of the earliest symptoms; the most serious is the spasm of the respiratory muscles. It's best if you have it. Have you had this shot before?
P: Yes. I had one about five years ago.
D: Well, I think you'd better have another one.
P: No problem.
D: Please come again five days later and so I can take the stitches out. Don't worry about your hand. It is going to be fine.
Nurse, Pay attention to the situation of this patient, and I'll show you how to do Dunlop's traction, as soon as he gets into the ward. Oh, yes. We will continue the traction for three weeks until the fracture is healed, or after ten days, when the fragment's become fixed together. Then we can replace the traction by plaster with the arm in flexion.
Feel free to contact us if anything happens!
P: Thank you, doctor. What should I do now?
D: First, you should get some rest, and get some regular sleep. Second, you shouldn't worry about your situation. I shall prescribe some medicine and tonic for you to quiet your nerves and increase your energy. That's all.
P: Ok, doctor. Thanks again.
参考译文
病人:您好!
医生:您好,请进来。什么事?
病人:李医生。刚才我正和同学打羽毛球,突然间我摔倒了,我的右肘很痛,我的手也不停地流血。事出突然,我不知道怎么处理。我很怕伤到我的臂部。您认为我有没有事呢?
医生:好,我先检查一下你的手。你的手还痛吗?什么时候发生的?
病人:还痛啊,半个小时前发生的意外。
医生:你能把袖子挽高一点吗? ... ... 好 ... ... 就这样。坐直点 ... ... 把手放在臀部 ... ... 好 ... ... 现在把手放在我的臀部,对。我想检查你的肘 ... ... 好。现在轮到另一边 ... ... 你现在躺下。把枕头放在右肩下 ... ... 把右手举过头。好 ... ... 左手也做同一动作 ... ... 好 ... ... 请起来。
病人:好的。
医生:脉搏、感觉都没事的。出力握住我的手 ... ... 哦!握力轻微减退。我想您最好拍个片。
病人:在这儿拍吗?
医生:不,护士会带你到X光室。我马上到那里。
(检查结果出来后)
病人:您好,医生。我已经拍了片。严重吗?
医生:从照片上看,你是鹰嘴骨折,看起来象横贯型。不是太严重,但它自己不会好。我想你应该住院做个手术。
病人:我要上学啊。一个月后我要期末考了。医生,请您帮帮我!
医生:我知道。但是当你的病情需要,你就要到医院来了。一旦手术做完,只需要住十天左右,你就会感觉好多了。要帮你登记轮候住院吗?
病人:好吧。
医生:我带你到入院办公室,作些必要的安排。好,让我们用几分钟讨论你的病情。我已经下医嘱在两天内密切观察你的病情,如果手变痛了,或变冷、变苍白、暗黑或肿胀了,护士会及时向我汇报。 ... ... 护士,给我一个缝合包。
病人:您打算给我的手缝针吗?
医生:是的,我想缝三针。不会很痛的,我会帮你固定好 ... ... 好,行了,不是太痛吧?
病人:不会。
医生:你最近打过破伤风疫苗吗?
病人:没有。我一定要打吗?
医生:是。破伤风是一种毒血症。毒素会播散到各个器官组织,牵涉到神经-肌肉接头部分,引起痉挛。咀嚼肌是最早受累的部分之一,最严重的是呼吸肌痉挛。所以你一定要打。以前打过吗?
病人:我五年前曾打过。
医生:行,最好还是再打一次 ... ... 你认为怎样?
病人:好的。
医生:你真幽默。好,五天后再来,我到时把线拆了,不要担心,这手会完全恢复的。
护士,请注意这个病人的情况,病人一入院,就作邓氏牵引。对了,必须牵引3周,直到骨折痊愈了,或者十天后,骨折碎片长在一块了,我们就可以撤掉牵引,用胶板把手固定在半屈位。
崔小姐,有什么事请跟我们联系。
病人:谢谢医生。我还要注意什么?
医生:第一,调整生活规律,要睡眠充足。第二,不必过分担心病情。我开些药和滋补品给你,镇静你的情绪,增加营养。就这样,再见!
病人:再次感谢您!再见。

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