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131尿床(儿童)

2017-12-27 50页 doc 205KB 3阅读

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131尿床(儿童)131尿床(儿童) 131(尿床(儿童) Enuresis(Children) Patient's Mother: My son wetted his bed usually( 病人母亲: 我儿子常尿床。 Doctor: When did he start to wet his bed? 医生: 他从几岁开始尿床的? Patient's Mother: Since childhood( 病人母亲: 从小就尿床。 Doctor: How often does he wet his bed? 医生: 尿多少次呢? ...
131尿床(儿童)
131尿床(儿童) 131(尿床(儿童) Enuresis(Children) Patient's Mother: My son wetted his bed usually( 病人母亲: 我儿子常尿床。 Doctor: When did he start to wet his bed? 医生: 他从几岁开始尿床的? Patient's Mother: Since childhood( 病人母亲: 从小就尿床。 Doctor: How often does he wet his bed? 医生: 尿多少次呢? Patient's Mother: Usually once or twice during the night( 病人母亲: 一般每夜一、两次。 Doctor: By the way,has he any abdominal pain? How is his appetite? 医生: 另外,他肚子疼过吗?胃口怎样? Patient's Mother: He suffers from abdominal pains once in a while(His appetite is not bad( 病人母亲: 他有时有腹疼。胃口不坏。 Doctor: I suggest you send in a specimen of his stool for examination to see whether it contains any parasites( 医生: 我建议你送个大便标本来化验一下,看有没有寄生虫。 Patient's Mother: I'II send it in tomorrow morning( 病人母亲: 我明天早晨就送来。 Doctor: Has he been given any other treatment? 医生: 以前做过什么治疗吗? Patient's Mother: He has taken some medicine before but it didn't work( 病人母亲: 他吃过一些药,但是不见什么效果。 Doctor: Acupuncture has some effect in enuresis,but we need your cooperation(We advise you to do the following(First,don't let the child take any water,milk or any liquid food after supper(Second,wake him up at a definite time during the night and let him void his bladder;he will thus gradually form a good habit(Third,better let the baby have a nap every day(Fourth,he must void his bladder before going to bed(Fifth,every morning,noon and evening press and knead between the thumb and the middle finger the spot in the ear where the small seed has been affixed with adhesive tape( 医生: 针灸治疗小儿遗尿有一定疗效,但需要你们和我们配合好。 应做到以下几点:第一,晚饭后不要再给他喝水、喝奶或吃 其他流质的东西。第二,每晚定时叫醒孩子起床撒尿,排空 膀胱;这样他就能渐渐养成良好的习 惯。第三,最好每天 让孩子睡午觉。第四,睡前一定要先小便。第五,每 天早、 午、晚用拇指和中指揉捏耳朵里用橡皮膏固定贴有籽粒的那 一小块地方。 1 132(耳聋(儿童) Deafness(Children) Parent's mother: Doctor,my boy can't hear properly( 病人母亲: 医生,我的孩子听不清。 Doctor: One ear or both ears?How long has he been suffering from poor hearing? 医生: 一只耳朵还是两只耳朵都听不清?有多久了? Parent's mother: From childhood(When he was one and a half years old。he had a higher fever。since then we noticed he can't hear properly( 病人母亲: 从小就聋。一岁半时他发一次高烧后,我们就发现他耳朵不太 好使了。 Doctor: Has he ever received streptomycin or kanamycin injections? 医生: 他注射过链霉素或卡那霉素吗? Parent's mother: He received seven injections of streptomycin when he got pneumonia two years ago(His hearing seems to have gotten worse since then( 病人母亲: 两年前他因为患肺炎注射过七针链霉素,从那以后耳聋就更加 重了。 Doctor: Is he suffering from ringing ears or from dizziness? 医生: 他有耳鸣或眩晕吗? Parent's mother: From neither( 病人母亲: 都没有。 Doctor: By the way(how old is he? 医生: 那么,他几岁了? Parent's mother: He is six years old( 病人母亲: 六岁。 Doctor: This kind 0f deafness is difficult to cure,acupuncture may have some effect but a prolonged treatment is needed( 医生: 这并不容易治好,针灸可能有些效果,但是需要长期治疗。 Parent's mother: All right,we are staying here for more than two months,please try to help him(Our whole family will be pleased if he shows even a little improvement( 病人母亲: 可以,我们要住在此地两个多月呢,请给他治治吧!假如他有一 点进步, 我们全家都会高兴的。 133(腰疼和坐骨神经疼 Lumbar Pain and Sciatica Doctor: In which area of your back do you feel pain? Only in the middle,or on the sides also? 医生: 你觉得你背部哪儿疼?只是在中间还是两边也都疼? Patient: Only in the middle part( 病人: 只是中间疼。 2 Doctor: Does the pain radiate to the leg? 医生: 疼往腿上窜吗? Patient: Yes,sometimes it radiates straight down to my heels( 病人: 是的,有时一直往下窜到脚跟。 Doctor: Can you move as usual? 医生: 你能像往常一样活动吗? Patient: I can move a little,but my motions are quite limited(I feel pain when It hurts when I stand up after sitting for a long period of bending down( time( 病人: 可以活动一点,可是非常受限制。弯腰时疼。坐久了,一站起来也 疼。 Doctor: Have you ever twisted your lumbar region? 医生: 你的腰扭伤过吗? Patient: I carried a heavy piece of luggage a week ago,I think maybe I twisted my back at that time( 病人: 一个星期前,我提了件重行李,我想可能那时扭的腰。 Doctor: Have you ever had any other illness,for instance nephritis,gall-stones or any gynecological diseases? 医生: 你有过其他病吗?比如说,肾炎、胆结石或妇科病? Patient: I have had nephritis,but that was five years ago( 病人: 我有过肾炎,但那是五年前的事了。 Doctor: When I press here do you feel any pain? 医生: 我用手压的这个地方疼吗? Patient: No,I don't( 病人: 不疼。 Doctor: I suggest you have an x-ray film taken of your lumbar region to get a definite diagnosis before we start the treatment( 医生: 开始治疗前,为了明确诊断,我建议你先拍张腰部的X线片。 Doctor: I am going to give you a shot of vitamin B12 and“danggui”solution into certain acupuncture points to relieve the pain(It's just like an injection and it only causes a slight pain( 医生: 我准备将维生素B1z和当归液注入针刺的穴位内,可以解除疼痛, 像打针一样只有轻微的疼。 Doctor: I am going to add electric acupuncture to the treatment(Don't be afraid, you will only feel a vibrating sensation( 医生: 我要给你加上电针治疗。不要害怕,电针只给你一种震颤的感觉。 Doctor: 1 would like to give you a cupping treatment,you will feel a tightening sensation in the local area only( 医生: 我要给你拔罐子,只是局部有点发紧的感觉。 134(理疗 Physiotherapy Doctor: 1 would like to arrange you to have three sessions 0f physiotherapy(Is it 3 convenient for you to come everyday? 医生: 我打算给你安排三次理疗。你每天都能来吗? Patient: I'm rather busy,but I'll try to come( 病人: 我很忙,但是我尽量来。 Doctor: How long has your leg(shoulder,lumbar region,hip)been hurting? 医生: 你的腿(肩、腰部、髋部)疼了多久? Patient: Already for half a year( 已经疼了半年。 病人: Doctor: Does the pain at the back 0f your shoulder move along your arms?Does it feel numb? 医生: 你肩膀后面的疼痛往胳膊上窜吗?有麻木的感觉吗? Patient: If I turn my neck,the back of my shoulder feels heavy,painful and numb(It moves along my right arm(I feel numb all the way to the tips of my fingers(The lumbar pain goes to the outside and back of my left leg(Can you tell me what is wrong? 病人: 假使我转动我的脖子,我肩膀后面就感到发沉,疼,麻木。它往我 的右胳膊窜。我觉得一直麻到指头尖了。腰部痛,疼痛还往我的左 腿的外侧和后面串。你能告诉我是什么病吗? Doctor: According to your symptoms and X-ray report,you are suffering from spur of cervical vertebrae(1umbar spine,knee joint)( 医生: 根据你的症状和X线片,你的颈椎(腰椎,膝关节)生了骨刺。 Patient: Is there any danger? What can I do to relieve the pain? 病人: 有危险吗?怎样才能解除疼痛呢? Doctor: Generally speaking,spur is degeneration of the skeletal system(It's a chronic disease associated with aging(There is no danger at a11(Better avoid too much exercises(Physiotherapy is sometimes helpful( 医生: 一般说来,骨刺是骨骼的退行性改变,是一种老年人的慢性病,根 本没有什么危险性。最好避免过量的活动。理疗有时有点帮助。 Patient: What kind of treatment are you going to give me? 病人: 你准备给我做什么治疗呢? Doctor: 1 would like to give you two kinds of treatments. One is an acetic acid ion transfer(It may reduce your pain and numbness(Another treatment is a traction of your neck(11 may widen the narrowing of the vertebrae and reduce the irritation 0n the nerves(muscles and other tissues to alleviate the pain( 医生: 我给你做两种治疗。一种是醋酸离子导人疗法。它可以减轻疼痛和 麻木。另一种是颈部牵引。它可以把椎间隙拉宽,从而缓解椎骨神 经、肌肉以及其他组织的刺激所引起的疼痛。 Patient: Does it hurt? 病人: 疼吗? Doctor: No,only a slight prickling sensation(There may be some itching of the skin after the treatment(You may apply some alcohol or glycerine 0n it(but don't scratch it(You must not break the skin,or we can't continue 4 the treatment( 医生: 不疼,只有轻微的针刺感。治疗后局部皮肤可能有些痒,你可以在 上面涂些酒精或甘油,但不要抓它。皮肤不能有创伤,否则就不能 继续进行治疗了。 Patient: Why? 病人: 为什么呢? Doctor: Even a very small lesion will cause a severe pain(The current will be concentrated 0n the lesion( 医生: 哪怕很小的一点创伤,都会引起剧烈的疼痛。电流将要集中在伤口 上的。 Patient: I see,by the way,how many times should I come? 病人: 我懂了。可是我需要来几次呢? Doctor: This treatment will last for 10 to 1 5 sessions(You can repeat it in two weeks if it is effective( 医生: 这种治疗需要持续做10至15次。如果有效的话,两周后再重复做。 Patient: Does traction cause any discomfort? 病人: 做牵引有什么不舒服吗? Doctor: No,don't worry(The weight we use is 10-20 pounds each time for 20 minutes(We can do it 10 to 15 times more(We start at 12 pounds(If you feel no Palpitation, dizziness or fatigue,we can increase the weight gradually(If you don't feel well,we can reduce it( 医生: 没有,不要有顾虑。用的是10至20磅(注:1磅约453(6克),每 次20分钟。可以 做10至15次或更多次。我们从12磅开始。假如 你没有心跳、头晕和疲劳的感觉,就可以逐渐增加重量。如果你感 觉不舒服,我们可以减少重量。 Doctor: How long has your finger been swollen and red? 医生: 你的手指红肿多久了? Patient: It has been hurting for about one week already,and has been red and swollen for two days(I did not bump(sprain,bruise)it( 病人: 已经疼了将近一个星期。近两天来又红又肿,我并没有碰伤(扭伤、 挫伤)它。 Doctor: It seems that the inflammation is localized and that there is some pus(Please register and see the surgeon( 医生: 看来炎症已局限在一个部位了,并且里面已经有脓了。请挂号看看 外科。 Doctor: Is the pain getting less severe? 医生: 疼痛减轻些了吗? patient( There is no change at a11(It remains swollen and painful( 疯人: 完全没有什么变化。还是又肿又疼。 Doctor: You need to see the surgeon again( 医生: 你需要再去看看外科。 * * * Doctor: 1 would like to give you the treatment 4,6 times.You can come 5 everyday every other day(What time do you refer? How about half past eight in the morning? 医生: 我给你做4至6次治疗。你每天来或隔天来都行。你愿意在什么时 间来?早晨八点半合适吗? I can't come in the morning(May I come in the afternoon? Patient: 病人: 我上午不能来。下午来行吗? Doctor: You may(Our clinic starts at half past two(Wednesday and Saturday we have no clinic in the afternoon so please don't come on those days( 医生: 可以,我们的门诊在下午两点半开始。星期三、六下午没有门诊, 所以请不要在那两天来。 * * * Doctor: (1)Please raise(extend)your arm( 医生: 请抬起(伸出)你的胳膊。 (2)Put your arm behind your neck( 请把你的胳膊向后伸。 (3)It is not necessary to take off all your clothing(Only expose the part where you feel pain( 不需要脱衣服。露出疼痛的部位就行了。 (4)After the treatment please raise your limbs for a while to improve your circulation( 做完治疗后请把胳膊腿抬起一会儿以改进血液循环。 (5)We'll use an electric current for treatment(There will be a slight prickling sensation(Please let me know if you feel any pain(I'll reduce the current( 我们要用电流做治疗。有一点轻微的针刺感。假若你感觉疼时就告 诉我。我可以降低电流量。 (6)I'll treat you with ultraviolet rays(It may diminish the inflammation and reduce the pain(Because the light is so strong I have to cover up your eyes to protect them(The treatment only lasts a few seconds(After that your skin may become red and tanned a little bit as if you had been sunbathing(It will fade away in a few days( 我要给你用紫外线治疗。它可以消炎止疼。因为光太强,为了保护 眼睛,需要将眼盖上。这治疗只有几秒钟。治疗后皮肤可以变红变 黑一点儿,就像晒过太阳似的。几天后就会褪去的。 (7)I’Il treat you with visible light and a kind of electric current(Visible light gives you warm sensation(The electric current has three types of waves(The first wave gives you a feeling of numbness(The second wave gives you a feeling of being lightly hammered(The third wave render the part numb from time to time( 我要用太阳灯和电流给你治疗。太阳灯给你一种温暖的感觉。电流 有三种不同的波。第一个波产生麻的感觉。第二个波有如小锤敲打 的感觉。第三个波是一阵一阵麻的感觉。 (8)H1 treat you with ultrashort wave(diathermy)(It might improve the 6 blood and lymph circulation so as to reduc6 the pain(You'll feel nothing during the treatment(Please don't apply any hot compress locally(During your monthly period the treatment should be stopped( 我将用超短波(透热疗法)给你治疗。它可以促进血液和淋巴循环从而 减轻疼痛。治疗时没有什么感觉。治疗后请不要在局部做热敷。来 月经时应停止治疗。 (9)I'll treat you with ultrasonic waves(It is helpful in absorbing scar formation and hard lumps(You will feel vibrations and warmth( 我要用超声波给你治疗。它有助于吸收癍痕和硬结。治疗中稍有震 颤和温热的感觉。 (10)We'll use whirlpool bath for your treatment(Put your arm (1eg)into the water,the bubbles in the water are a form of massage(The warm water will improve your circulation( 我要用漩水浴给你治疗。将你的胳膊(腿)放入水里,水中的水泡可以 起到按摩的作用。温热的水可以促进你的血液循环。 (11)We'll give you laser treatment(Don't worry(You won't feel anything during the treatment(Please don't look at it directly(Put on these dark glasses( 我要用激光给你治疗。请不要怕。治疗中没有什么感觉。眼睛不要 直接看着它。请你戴上墨镜。 (12)We'd better use interference current therapy in your case(You’ll feel numbness,trembling and chafing(Please tell me if you think it is t00 strong(I'll adjust the amount of current( 你的情况最好用干扰电流治疗。治疗中你会有麻、震和按摩的感觉。 假如你感觉电流太强,请告诉我。我给你调节一下电流量。 (13)I'll use a kind of electric current therapy in your case( It can help stop itching,act as a pain-killer,improve the circulation and metabolism(Take off everything made of metal that you are wearing(There is only a pricking sensation(After the treatment you will feel quite comfortable( 我要用一种电流疗法给你治疗。它有止痒、镇痛、促进血液循环及 营养代谢作用。请把身上带的一切金属制品摘下来。只有一种针刺 感。治疗后你会感到很舒服。 (14)I'll treat you with paraffin therapy(Please don't move during the treatment(Don't hesitate to tell me if you feel too hot( 我要用石蜡给你治疗。治疗时不要动。若感到太热就马上告诉我。 (15)This is your card for physiotherapy(Please take this to the cashier where you pay(Whenever you come please show us this card( 这是你的理疗卡片。请拿着它到收费处交费。每次来时我们要看看 你的卡片。 135(在急诊科 In the Emergency Department 7 Head: Good morning,boys(Welcome to our department(It’s your first day to work and study here(I'd like to show you around first,so you'll get familiar with the arrangements and the facilities( 主任: 早晨好!同学们。欢迎到我科,这是你们到此工作和学习的第一天, 我想先带你们参观一下,以便了解这里的布局和设备。 Interns: Thank you,doctor(That will be very helpful( 实习生: 谢谢您,医生,这会非常有帮助。 Head: Oh,boys,let's start from the very beginning(This is a typical and well-equipped emergency department(There are two entrances to the building,one for ambulance patients,and the other for walking patients( 主任: 噢,同学们,让我们从头看起,这是个的、设备齐全的急诊科。 有两个人口:救 护车的病人人口及步行病人人口。 Interns: Do the doctors have to help bring the patients in as the ambulance arrives? 实习生: 救护车到来时,必须有医生帮助搬运病人吗? Head: No,we have porters doing that,who are trained to carry patients with different injuries or diseases。usually using stretchers or trolleys(Here is the porters'room( 主任: 不,我们有专门的搬运人员完成此项工作,他们受过搬运各种病人、 伤员的训练。搬运工作通常借助于担架或平车。这儿就是搬运人员 房间。 Interns: To which room will the patients be taken firstly? 实习生: 病员首先搬人哪个房间? Head: Normally to the examination cubicles,however,when the patients, conditions are very critical(I mean the patients with severe cardiac attack,especially at risk from cardiac arrest(the patients with coma and respiratory failure,as well as with severe injuries,we put them into the resuscitation room directly((pointing to the room)It's on the right side of the entrance( 主任: 一般先搬至检查室;如情况紧急,如心脏病患者有心脏骤停危险, 昏迷病人,呼吸衰竭病人及严重创伤患者可直人复苏室。它位于出 口的右侧。 Interns: This must be one of the most important rooms in the hospital(Will we come in for a look? 实习生: 它必定是院内最重要的房间之一,我们能进去看看吗? Head: Of course((after going inside the room)Well,the room is a bright,spatial and well-equipped one(as you see(Every medical staff in our department should be able to use the basic apparatus in this room(On the wall is the oxygen pipe and the suction pipe。at the left corner the portable X-ray machine and the cardiac resuscitation trolley(and on the right side the cardiac monitoring machine. 主任: 当然可以。 8 (进屋后)这房间宽敞、明亮、设备齐全。我科每个工作者都必须会使 用此房间内的基本医疗仪器。墙上是氧气管道和负压吸引管道;左 侧墙角处为便携式X光机及心脏复苏车;右面为心电监护仪。 Interns: What will we do with the patient once the preliminary treatment is finished? 实习生: 初期治疗完成后如何进一步处理病人? Head: Usually we send the patients to special departments in this hospital when the patients,condition are comparatively stable and further treatments are indicated. But,if the patients have been largely recovered,we prefer to put them into the observation ward over there for short term observation and treatment( 主任: 通常待病人病情相对稳定,患者又有进一步治疗指征,我们即将患 者送入院内特定科室。但如患者已基本恢复,我们多将病人置于观 察病房,进行短期观察治疗。 Interns: More often than not we saw the emergency departments of hospitals seemed to be the noisiest and most disordered places(But this one is clean and quiet( 实习生: 我们过去所见的医院急诊室多半是吵闹不堪,毫无秩序,但这儿的 急诊室既清洁又安静。 Head: We have many facilities to cope with special cases(Take for example, the sound- attenuated room near the closet(drunks or patients with psychiatric disturbance are always brought into it( 主任: 我们有很多设施处理特殊情况,例如前面清洁间旁边的隔音房间, 醉汉、精神异常 患者常被置于其内。 Interns: That's really a wonderful emergency department( 实习生: 真是个好急诊室。 136(转诊 Transfering Consultation Doctor: Good afternoon,Mrs(Wilkins(You've come to us fromDr(Johnston?What took you to him? 医生: 你说,威尔金斯太太。你是从琼斯顿医生那转来的吗?有什么不舒服 吗? Patient: It's my periods(They've been playing me up( 患者: 我的月经有问题,月经一直不好。 Doctor: I'm sorry(In what way are they bothering you? 医生: 对不起,能讲具体些吗? Patient: They're so heavy and I feel so queer when I'm o n(I still see monthly but they last eight or ten days(During the periods,I pass clots and it hurts(You know, doctor(I can not go to my work while I like it( 患者: 月经量太多,每次月经期间我都感到头晕。尽管还是每月一次,但 每次持续8到10天。每次月经中都有血块,还伴痛经。大夫,你知 道吗?我是很喜欢自己的工作的,但现在我连班都上不了了。 9 Doctor: When was your last period? 医生: 上次月经是什么时候来的? Patient: Let me see(It was the week before Whitsun(That's two weeks ago( 患者: 让我想想,大约是在降灵节前那个星期,也就是两周之前吧。 (Doctor examines patient and finds a large mass of uterine fibroids() (医生检查了患者,发现了一个大的子宫纤维瘤。) Doctor: Well,Mrs(Wilkins,you've got some lumps of fibrous tissue on the womb which are causing the bleeding(I think we should deal with them( 医生: 威尔金斯太太,你的子宫上长了些纤维组织块,月经过多正是由此 引起的,我们得把这些纤维组织去掉。 Patient: Oh(Is that serious? 患者: 天啊!严重吗? Doctor: No(It's not but it won't get better on its own accord(I'd recommend you to come in and we'll deal with the situation by operation( 医生: 不严重,但不会自行好转,我建议你住院采用手术治疗。 Patient: I suppose you know best but I'm frightened 0f hospitals( 患者: 我想你最了解病情,可我害怕住院。 Doctor: I know but hospitals are useful places to turn to when you need them(You'll only be in for ten days or so and once the operation is over, you'll feel so much better( Shall I put you on the waiting list? 医生: 我理解你的心情。可在必要时,住院对于你疾病的恢复是有益的。 而且你只需住院10天左右,做完手术就会好的。我可以为你填写住 院预约登记吗? Patient: I suppose s0(Thank you for your help( 患者: 那就这样办吧。谢谢你的帮助。 137(会诊 Consultation (1) Consultant:Hi,Tom(Did you call for me? 会诊医生: 喂,汤姆,是你在叫我吗? Resident: Yes(I did(I've got a hot case( 住院医生: 是的。我收了一名发热患者。 Consultant:Fill me in on the story( 会诊医生: 请将病史向我报告一下。 Resident: He's a 22-Year-old male who was in good health prior to last night(Last night the pain was colicky in nature,periumbilical,and rather sporadic(The patient had about five episodes of nausea and vomiting associated with this pain last night(He has been anoretic,has had no bowel movements for two days,and has had no episodes of diarrhea(The pain had migrated to the right lower quadrant and is steady in nature of 39(5oC since yesterday(There have been no episodes of coughing with expectoration,shortness of breath,or burning in the 10 epigastrium(The pertinent physical findings are related to the abdomen(His chest is clear(The patient was lying still in bed,trying to avoid movement as much as possible(There is extreme tenderness in the right lower quadrant,especially over McBurney's point(Guarding, muscle rigidity,rebound,and referred tenderness are all present(Bowel sounds are markedly decreased( 住院医生: 患者男性,22岁,既往健康。昨夜开始偶发脐周绞痛,同时伴5次 恶心、呕吐。患者食欲差,近两天无排泄,无腹泻史。后来腹痛转 至右下腹并呈固定性质。昨日以来体温39(5?。无咳痰,无气短及 上腹灼痛史。有关的体格检查结果与腹部情况有关。其胸部正常。 患者静卧于床,尽量避免活动。右下腹压痛明显,尤以麦氏点为甚。 有肌卫、肌紧张及反跳痛,肠鸣音明显减弱。 Consultant:Let me just go in and see him for a few minutes( 会诊医生: 先让我进去看看病人。 (A moment later) (过了一会儿) Consultant:Are the lab results back yet? 会诊医生: 化验结果回报了吗? 9Resident: He's got a white count of 15 000(15×10,L)with 80,polys and a shift to the left(Hemoglobin and hematocrit are normal,as is his urinalysis(His chest film is clear( 9住院医生: 他的白细胞为15 000(15×10,L)中性粒细胞占0.80,有核左移,血 红蛋白,红细胞压积正常,尿化验正常。胸片无异常发现。 Consultant:Well,I think he has appendicitis(Put down a gastric tube and aspirate the contents(I'll call my attending now and meanwhile,the orderly will take him up to surgery( 会诊医生:嗯,我考虑他得的是阑尾炎。请立即放人胃管吸出胃内容物,我马上 通知我的住院医师,并让护理员立即送病人到外科去。 (2) Attending:Has any of his lab work come back? 主治医师:他的化验结果有回报的吗? Intern: Yes,I've got a few of them here(Both the direct and indirect bilirubin are elevated(The urine bilirubin and urobilinogen are slightly increased(The ceph floc was+++。and the thymol turbidity was 5 units(The rest of the studies haven't come back( 实习医师: 有,我这儿有几项化验结果。直接胆红素和间接胆红素都升高。尿 胆红素和尿胆素原也轻度增加。脑磷脂胆固醇絮状是+++,麝香草脑 混浊度是5个单位。其余的化验结果还没有回报。 Attending: What else did you order? 主治医师: 你还让做过别的化验吗? Intern: The routine urinalysis,CBC,FBS,BUN,VDRL,and AP and lateral of the chest(Besides those。I got a total serum protein and an AG ratio, alkaline phosphatase,PT time,and SGOT( 11 实习医师: 常规尿分析、全细胞计数、空腹血糖、血尿素氮、VDRL梅毒血清 学试验以及拍前后和侧位胸部X线片照片。除上述检查外,还做了 血清总蛋白、AG比率、碱性磷酸酶、凝血酶原时间和血清谷草转氨 酶。 Attending: Did you get a blood ammonia? 主治医师: 你做血氨了吗? Intern: No,I didn't( 实习医师: 没有,没有做。 Attending: Well,I think we'd better get one( 主治医师: 哦,最好是立刻做一个。 Intern: Are you thinking of coma? 实习医师: 你在考虑昏迷吗? Attending: Yes,I think we'd better observe this patient carefully(I think you ought to start an IV of D5W 1000cc(Withhold proteins from him for the time being(He can have nutritional vitamins( 主治医师: 是的,我们最好是仔细的观察这个病人。我认为你应该开始(给他) 静脉点滴5,葡萄糖溶液1000毫升。暂时不给他蛋白质。他可以进 多种有营养的维生素。 Intern: How about Neomycin sulfate 0.5g(q6h? 实习医师:给(他)硫酸新霉素0.5克,每6小时一次怎么样? Attending: I'd start that immediately(I'd also put a gastric tube down and check to see we get any blood back(Just try to be very careful with it( 主治医师: 我打算立即开始给(他)硫酸新霉素。还要下一根胃管,并检查一下看 是否有回血。要非常小心地下胃管。 Intern: Do you have any objection if I order a Sengstaken tube? 实习医师:如果我让下一根森氏管你同意吗? Attending:Not at a11(I think it's a good idea( 主治医师:同意。我认为这是一个好主意。 138(取药 Having the Prescription Filled (1) Patient: Excuse me,is this the pharmacy? 病人: 对不起,这是药房吗? Pharmacist:Yes,what can I do for you? 药师: 是的,能为您做点什么? Patient: I'd like to have my prescription filled( 病人: 我要拿药。 Pharmacist:t-land me the prescription,please((after filling the prescription)Here is your medicines,Madam( 药师: 请递绘我处方(药物配齐舌)女士,这些是您的药。 Patient: My God! S0 many drugs! Could you give me an explanation? 病人: 上帝啊!这么多药!能解释一下用法吗? 12 Pharmacist:Ok(You have 5 kinds of medicines in hand(In the small bottle is spiromycin tablets(Take two tablets each time,twice a day,better after meal(Take one tablet of this painkiller if you feel pain(But not more than one every four hours( 可以,您手中现有5种药物,小瓶内装有螺旋霉素,每次服用2片,药师: 每天2次,最好于饭后服用。感到疼痛时服用1片止痛药,但4小 时内不能多于1片。 Patient: How about this liquid? Is it for internal use,too? 病人: 瓶内液体如何用?也是内服药吗? Pharmacist:Yes(It's for relieving your abdominal pain(Drink one line each time, 3 times a day(Shake it well before taking it( 药师: 是的,是为减轻腹痛的。每次1格,日服3次。服前摇匀。 Patient: What's in this yellow bottle? 病人: 此黄瓶内是什么药? Pharmacist:It's vitamin E(You should take it 3 times a day(One capsule each time(And that is vitamin C(I suppose you know how to use it( 药师: 是维生素E,日服3次,每次1丸。这是维生素C,我想您知道如何 服用。 Patient: Yes,I'm in the habit of using 6 tablets each day every time I catch cold( Thank you very much( 病人: 是的,我感冒时习惯每天服用6片。非常感谢。 (2) Patient: How do I take these medicines? 病人: 我怎样服这些药呢? Pharmacist: (1)One tablet,three times a day( 药剂师: 一天三次,一次一片。 (2)Two tablets,four times a day( 一天四次,一次两片。 (3)Two tablets at night( 晚上服两片。 (4)Take one tablet of this pain-killer if you feel pain,but not more than once every four hours( 假如你觉着疼就吃一片止痛片,但每次必须间隔四个小时。 (5)One line(half line)three times a day(Shake it well before taking it( 每天三次,每次一(半)格。服用前摇匀。 (6)Please put it under your tongue,don't swallow it( 请把药放在舌头底下,不要往下咽。 (7)Please suck it( 请含服。 (8)Please dissolve the pill in water before taking it( 服前请将药丸放在水中溶化。 (9)One teaspoon three times a day( 每天三次,每次一茶匙。 13 Patient: How do I use this suppository? 病人: 我怎样用这栓剂呢? Pharmacist: Insert one into your anus(vagina)every night( 药剂师: 每晚塞一个在肛门(阴道)内。 Is this for internal use too? Patient: 病人: 这也是内服药吗? Pharmacist: (1)This is for gargling only( 药剂师: 这是含漱剂。 (2)This will loosen your stools(Please squeeze it into your anus every night( 这是通大便的。请每晚往肛门里挤一些。 (3)This is a special adhesive for easing the pain(Apply it to the painful area and change it every two days( 这是专为止痛用的药膏。贴在痛处,两天换一次。 (4)Apply some of the ointment,and rub it into the skin( 涂一些这种药膏并揉进皮肤里去。 (5)Paint this lotion to the itching spot with this small brush(cotton swab)( 用小刷子(棉花棍)把洗剂涂在痒处。 (6)Please dissolve the tablet(powder)in hot water(Soak your hand(foot) in it for twenty minutes twice a day( 请将这药片(药粉)溶化在热水里。将你的手(脚)泡在里面,每日两 次,每次20分钟。 Patient: How do I use these eye-drops and ointment? 病人: 我怎样使用这些眼药水和眼药膏呢? Pharmacist:Put the eye-drops into your right eye 4-6 times a day,each time one to wo drops(Squeeze a bit of the ointment on your eyelid every night. 药剂师: 将这种眼药水滴人右眼,每天四至六次,每次一、两滴。每晚往眼 皮里挤一点眼药膏。 Patient: How do I apply the nose drops? 病人: 我怎样使用这滴鼻剂呢? Pharmacist:Bend your head back as far as possible and then put them。 药剂师: 尽量把头向后仰然后将药滴进去。 Patient: How do I apply the ear drops? 病人: 我怎样使用滴耳剂呢? Pharmacist: Turn your head to the side,put one to two drops in your ear.Press the tragus for a few seconds( 药剂师: 将头歪向一侧,往耳朵里滴一、两滴药水,再把耳屏按几秒钟。 Patient: How do I take (make) the herb medicine? 病人: 我怎样服(熬)中药呢, Pharmacist: (1)Put the herbs into a pot(Add about 300 c.c(of cold water. Simmer gently for 20 minutes(Drain the solution(The amount left will be 4U to 50 c(c(This is the first dose(Don't throw the herbs away.Do the 14 same in the evening(That is the second dose(Take the first dose in the morning,the second in the evening( 药剂师: 把草药放进锅内。加入300毫升冷水。用慢(文)火煎20分钟, 将药水滗出,约40,50毫升。这是头煎。不要将药扔掉。仍照原 法下午再煎一次,这是二煎。头煎早晨服,二煎晚上服。 (2)We can make the solution for you for six days(Take one bottle daily,halt in the morning(half in the evening(Please put them in the refrigerator 0r keep them in a very cool place(Don't take the medicine while it is cold. 我们可以给你煎出六天的药。每天服一瓶,上午半瓶,下午半瓶。 瓶子要放在冰箱里或是凉爽的地方。不能服冷药。 Patient: Must I boil it before taking it? 病人: 每次服以前要将它煮开吗? Pharmacist: No(Put it in a glass and warm it in a bowl of hot water. 药剂师: 不必。可以将药盛在玻璃杯里,将它放在一碗热水中加温。 Patient: How do I take these big balls? 病人: 这些大药丸儿怎么服呢? Pharmacist: Chew and swallow the bits with water or put them in water t0 melt them. Remove the wax before taking it( 药剂师: 把它掰成小块,嚼后用水咽下,或者把它泡在水里化开再喝。服 前把蜡去掉 139(查房 Ward Round (1) Attending: Let me tell you the schedule for this morning(We'll make a round of wards first and then discuss the patient's condition( 主治医生: 我讲一下上午安排,先查房,然后讨论病例。 Resident: Which case? 住院医生: 哪个病人? Attending: The patient in bed No(9(How long has he been in hospital? 主治医生: 9床。他住院多长时间了? Resident: For one week( 住院医生: 一周。 Attending: When he was admitted what positive signs did you find? 主治医生: 入院时有什么阳性体征? Resident: I've taken a thorough physical examination on him and found nothing abnormal except a mild fever(His general condition is good( 住院医生: 系统查体没有什么异常发现,只是有些发热。一般情况良好。 Attending: Has the fever remained the same or varied? 主治医生: 体温还高吗? Resident: It went down to normal yesterday( 住院医生: 昨天已降至正常了。 15 Attending: What studies did you use to substantiate you diagnosis? 主治医生: 为了证实诊断,都做了什么检查? Resident: The routine urinalysis,stool analysis,CBC,FBG,BUN,Cr,„, and so on(The white blood count showed leucocytosis,and the others were all normal( 住院医生: 尿、便常规、血常规、空腹血糖、血尿氮、肌酐等。除白细胞高外, 其他均正常。 Attending: Have you taken chest film? 主治医生: 拍胸片了吗? Resident: Yes,but no report from the department of radiology( 住院医生: 拍了,放射科还没发报告。 Attending: I think you should reexamine his CBC now( 主治医生: 你该再复查一次血常规。 Resident: Yes,I did it last night,and the leueocytosis was still present( 住院医生: 昨晚查了,白细胞还高。 Attending: What does the cardiogram show? 主治医生: 心电图结果如何? Resident: I don't think ECG will be necessary for this kind of disorder( 住院医生: 我想这种病不必查心电图。 Attending: You'd better get one( 主治医生: 你还是查一次的好。 Resident: I'll write the order right now( 住院医生: 我这就下医嘱。 Attending: Would you consider an echogram? 主治医生: 准备查超声波吗? Resident: Yes,1 would(But not at present( 住院医生: 是的,但眼下还不行。 Attending: Why not? 主治医生: 为什么? Resident: It has been arranged and I guess that he will be examined in about one week. 住院医生: 已经安排好了,大概要等一周左右。 Attending: What's the report 0f HBsAg determination? 主治医生: 乙肝表面抗原检查结果是什么? Resident: It's negative( 住院医生: 阴性。 Attending: Did you get AKP measurement? 主治医生: 查碱性磷酸酶了吗? Resident: It’s among the normal range( 住院医生: 在正常范围内。 Attending: What else did you order? 主治医生: 你还下了什么医嘱? Resident: Blood and mid-stream-urine culture as well as sensitivity test(But I 16 haven't known the results yet( 住院医生: 血和中段尿培养及药敏试验,现在还没结果。 Attending: Very good(Let us have a look at the patient now( 主治医生: 很好,现在我们看一下病人吧。 (2) (One week later,the attending physician Zhao followed by some interns makes the rounds of the wards) (一周后,赵主任医师带领实习生们查房) Attending physician Zhao(Zhao): Hello,Zhang,how are you feeling now? 赵主任医师: 喂,老张,你现在感觉怎样? Patient Zhang(Zhang): I feel better than before(The urine becomes clear and increases in quantity. 病人张: 我觉得比前些日子好些了,尿变清了,量增多了。 Zhao: How about the blood pressure,Dr(Li? 赵: 血压怎么样,李医生? Dr.Li(Li): Well,about 130,140,70,80mmHg,it’s normal( 李医生: 大约在130,140,70,80mmHg,正常范围。 Zhao: What about the renal function? 赵: 肾功能怎么样? Li: The endogenous creatinine clearance rate was 55ml,rain soon after admission,renal insufficiency(Now it's 95mlmin,becomes normal( 李: 人院后不久内生肌酐清除率为55ml,min。肾功能不全。现在是95ml ,min。正常肾功能。 Zhao: Is there any trouble with the heart? 赵: 心脏有什么毛病吗? Li: No,there isn't( 李: 没有。 Zhao: What about other symptoms(such as the pharyngotonsillitis and edema? 赵: 其他症状怎样,例如咽扁桃体炎及水肿? Li: His throat looks good(Edema 0f lower limbs and the puffiness of eyes have disappeared( 李: 他咽部已正常,下肢及眼睑水肿已消失。 Zhao: That's very good(He recovers very rapidly(Interns,this is a typical case of acute nephritis(We'll discuss the diagnosis,the differential diagnosis and the treatment of acute nephritis soon after we finish our rounds( 赵: 那太好了,他恢复很快。实习医生们,这是一例典型的急性肾炎, 我们查房后将讨论急性肾炎的诊断,鉴别诊断及治疗。 Zhao: Sit down,please(Now we’ll discuss some problems of acute nephritis based on the patient we have just seen before(D r(Liu,would you please tell us what are the clinical manifestations of the acute nephritis。 How to diagnose it and how to treat it? 赵: 请坐,现在通过刚才看过的病例来讨论一些有关急性肾炎的问题。 刘医生,你能谈谈急性肾炎的临床表现,如何诊断与治疗吗? 17 Dr(Liu: There are many manifestations of the acute nephritis. Among the most commonly seenare edema,hematuria,albuminuria,and hypertension(Clinically if the above symptoms occur secondary to the streptococci infection in the throat or on the skin,the diagnosis is not difficult to make(If the clinical symptoms are vague,careful examination(especially repeated urinalysis are necessary to make a definite diagnosis(As to treatment,rest,low-salt and low-protein diet, anti-infection, Chinese traditional medicine and heteropathy all are important to the cure of acute nephritis( 刘医生: 急性肾炎临床表现很多,主要是水肿、血尿、蛋白尿及高血压。临 床上,如果继发于咽喉部或皮肤处链球菌感染出现上述症状,诊断 多无困难:如果症状不明显,须详细检查,特别是反复查尿常规方 能确诊。治疗应为休息,给低盐低蛋白饮食,控制感染,中药治疗 及对症处理。 Zhao: Above is the principle of the diagnosis and treatment 0f the acute nephritis Next 1et's discuss the differential diagnosis of the acute nephritis As we know,acute nephritis should be differentiated from acute infection,anaphylactin,collagenosis and other disease 0f the kidney(First,I'll tell you how to differentiate it from acute infection. During the period 0f acute infection,the fever often causes slight microscopic hematuria and albuminuria(Follow-up studies is necessary in order to see if the hematuria and albuminuria vanish shortly after the temperature becomes normal(?it does occur,it’s acute infection(Anaphylactoid purpura may have hematuria and edema(but it has some specific clinical manifestation(Dr(Sun,what are the characters 0f the anaphylactoid purpura? 赵: 以上是有关急性肾炎的诊断及治疗原则,现在我们讨论一下急性肾 炎的鉴别问题,我们都知道,急性肾炎应与急性肾感染,过敏性疾 病、胶原性疾病及其他肾脏疾病相鉴别。下面首先谈一下如何鉴别 急性肾炎与急性感染。在急性感染过程中,发热可能导致轻微镜下 血尿及蛋白尿,需随访看热退后短期内血尿及蛋白尿是否消失。若 消失,则为急性。肾感染。过敏性紫癜可能伴有血尿及水肿,但存 在某些特征性临床表现。孙医生,过敏性紫癜的特征是什么? Dr(Sun: Er,let me see(((Anaphylactoid purpura has obvious purpura, arthralgia or abdominalgia( 孙医生: 哦,让我想想„„过敏性紫癜有明显紫癜,关节痛或腹痛。 Zhao: Yes,indeed(These are the difference between them(Collagenoisis such as lupus erythematosus may also have hematuria。edema and So on(But there are clinical manifestation such as erythema,symptoms 0f the ioint and heart in it which can work as the differential point. Other diseases 0f the kidney can be differentiated from acute nephritis onthe basis 0f symptoms,signs and various examination. You can look them up h your book(Well,time is up(If you have any questions, 18 remember to tell me next time(Good-bye,everyone( 赵: 对,这些就是两者的区别点,胶原性疾病如红斑狼疮病,也可有血 尿、水肿等 它有红斑,关节及心脏症状,可资鉴别。至于其他肾脏 疾病的鉴别主要靠症状,体征及各种检查,你们可以查查。好的, 时间到了,若有问题课后告诉我,下一次解答,再见,同学们。 140(术前讨论 Preoperative Discussion (1) Chief resident:Let's have a short discussion about the case of bed No(4,Room 401(Dr(Li,will you tell us the brief history of Mr(Wang Min? 总住院医生: 我们讨论一下401病室4床的病例,请李医生对王敏先生的病史 做—扼要介绍。 Resident: He's a 24-year-old male who was in good health prior to 1ast night(Last night at about 8:00 pm the pain was colicky in nature, periumbilical and rather sporadic(The patient had about three episodes of nausea and vomiting associated with pain last night(He has been anorectlc'has had n0 bowel movements for two days,and has had n0 episodes 0{diarrhea.The pain has since migrated to the right lower quadrant and is steady in nature(There have been no positive sign about respiratory system and no burning sensation in the epigastrium(The patient physical findings are related t0 the abdomen(His chest is clear(The patient was lying m aflexion position in bed,trying to avoid movement as much as possible.There is extreme tenderness in the right lower quadrant,especially over Mc Burney's point(Guarding,muscle rigidity,rebound and referred tenderness are all present(Psoas stretch is positive and there was no tenderness on rectal examination(Bowel sounds are remarkly decreased. 住院医生: 病人系24岁男性,自昨夜起发病,以往身体健康,昨夜8点钟 开始感觉脐周围有阵发性绞痛,疼痛时曾有三次恶心呕吐。病人 缺乏食欲,二天来未解大便,无腹泻。随后腹痛转移至右下腹持 续至今。呼吸道方面无阳性体征。上腹部亦无烧灼感。主要体征 在腹部,胸部听诊清晰。病人蜷曲卧位尽量避免活动。右下腹压 痛明显,尤其在麦氏点。有肌紧张,反跳痛及转移痛。腰大肌试 验阳性,肛门指诊无压痛,肠鸣明显减弱。 Chief resident: What's his temperature and blood pressure? 总住院医生: 体温及血压多少? oResident: Temperature is 37(8C(centigrade),and the BP is 120,80(16, 10.6kPa). o住院医生: 体温是37(8C,血压是120,80(16,10.6kPa)。 Chief resident: Are the lab results back yet? 总住院医生: 化验报告回来了没有? 19 9Resident: He's got a white count ofl2 000(12×10)with 80, polys and a shift to the left(Hemoglobin are normal,as is his urinalysis(Fluroscopy of the chest is normal( 9住院医生: 病人的白细胞记数是12000 (12×10),中性0.80,有左移现象, 血红蛋白及尿化验均正常,胸透正常。 Chief resident: What's your idea about diagnosis and treatment? 总住院医生: 你认为是什么诊断?并如何处理? I think he has acute appendicitis and better to have an operation. Resident: 住院医生: 我认为病人患的是急性阑尾炎,最好进行手术治疗。 Chief resident: Well,I agree(This is a typical case of acute appendicitis.Why don't you go to the ward and tell him what we're going to do? 总住院医生: 我同意你的诊断意见,这是一个典型急性阑尾炎病例,你到病房 去告诉病人 我们的决定。 * * * Resident: Mr(Wang,do you have relatives here? 住院医生: 王先生,你有亲属在本地吗? Patient: No,not a sole( 病人: 本地没有亲属。 Resident: We think that you have appendicitis,and it's going to be necessary to operate on you to relieve your condition( 住院医生: 我们认为你患了急性阑尾炎,需要施行手术治疗。 Patient: Is it serious? 病人: 病情严重吗? Resident: It could be if we don't operate( 住院医生: 不做手术可能加重。 Patient: How you think it's necessary,then go ahead(Anything to get rid of that awful pain. 病人: 你们认为需要就手术吧,只要不疼就行。 (2) Attending: What is the late complication of radical mastectomy? 主治医师: 乳房根治切除术的晚期并发症是什么? Intern: Edema of the arm,that is,the lymphatic drainage is compromised, and infection is more likely to occur( 实习医师: 是胳臂水肿。也就是淋巴引流受到损害,而且很容易发生感染。 Attending: What is the five-year cure rate of all patients treated by radical mastectomy? 主治医师: 所有用乳房根治切除术治疗的病人其五年治愈率是多少? Intern: About thirty percent? 实习医师: 大约30,吗? Attending: About forty to sixty percent,and where there appears to be no evidence of metastases,as in this lady,it would be 75 to 85 percent(That is the five year clinical cure(What is the most unfavorable site for carcinoma of the breast? 20 主治医师: 大约40,,60,,至于没有出现转移证据的病人,像这位女士, 五年治愈率可能是75.9,6,85,。这就是五年临床治愈率。乳 癌最不利的部位在哪里? Intern: Inner lower quadrant( 实习医师: 在内下象限。 Attending: That's right . Well,I think you know what has to be done,1 would get a surgical consultation immediately(A frozen section will probably be following,and,if this is carcinoma,which I think it is, a radical mastectomy would be the procedure 0f choice(If the axillary nodes are involved,there is a good chance that the internal mammary chain is involved,and the surgeons would probably then do an excision 0f this chain(Please let me know what develops( 主治医师: 对了。喔,我想你知道应该做什么了。我要立刻请外科会诊。接 着可能要做一个冰冻切片,如果这是癌,正如我所猜测,那么应 行乳房根治切除术。如果腋窝淋巴结受侵犯,那么乳房内淋巴结 受侵犯的可能性就很大,那时外科医生大概要做淋巴结清扫,发 生什么情况请告诉我。 Intern: We certainly will(Thank you for seeing the patient. 实习医师: 我们一定照办。谢谢你看了这位病人。 141(量体温 Take the Temperature Doctor: Do you have a fever? 医生: 您发烧吗? Patient: Yes,I do(I feel ghastly(My cheeks are burning(It started with a chill and fever( 病人: 是的,我觉得很不好,我的两颊很烫,开始时又冷又热。 Doctor: You look ghastly too(You must have a high temperature. I’d better take your temperature(Where's the thermometer? 医生: 您看起来是很不好,您肯定发高热,我来量一下您的体温。体温 表在何处? Nurse: Let me take his temperature(Please,put this thermometer under your tongue(Let me feel your pulse„(Give me the thermometer. 护士: 我来量他的体温吧。请把这温度计放在您的舌下,让我摸摸您的 脉搏。„„把体温表给我。 Doctor: What is it? 医生: 多少度? Nurse: Thirty nine point eight degrees centigrade. 护士: 39.8?。 Doctor: Pretty high(I expect it's flue(Many people have it. 医生: 太高了,我看是流感,很多人患流感。 Nurse student: How many times a day should this patient have his temperature taken’nurse? 21 护士生: 老师,这个病人一天量几次体温? Nurse: The patient should take his temperature twice a day at least.If it is still pretty high it must be taken every four hours or even every two hours. 护士: 这个病人应该至少一天量两次体温。如果仍然很高,应该每4小 时甚至每2小时量1次。 Nurse student:When I take his temperature should I count his pulse too? 护士生: 我量体温时还要数他的脉搏吗? Nurse: Yes,you should not only take the pulse but also count his respiration. It is necessary to be careful when using the thermometer! Because should the patient break it and swallow the glass or mercury it would be very dangerous( 护士: 应该数,不仅要数脉搏还要数他的呼吸。用体温计时必须小心。 因为病人如果把体温表咬碎,吞下了玻璃或水银,那是很危险的。 Nurse student: Some patients are delirious(How shall I take his temperature? 护士生: 有些病人是谵妄,我如何测他的体温呢? Nurse: Take it by rectum, Be careful that the anus is clean(Hold the thermometer in for three to five minutes(If the patient's mouth is sore,take his temperature by axilla. 护士: 可以通过直肠量体温,但应小心,肛门要清洁。把体温计放置3, 5分钟。如果病人口腔有疮,可以通过腋下测体温。 Nurse student: How long shall I leave the thermometer in the axilla? 护士生: 在腋下测体温需放置多久? Nurse: Ten minutes. 护士: 10分钟。 Nurse student: What are the different kinds of fever,doctor? 护士生: 医生,体温类型有几种? Doctor: There are continuous fever like pneumonia,scarlet fever and typhus; remittent fever like typhoid and septic fever and intermittent fever like malaria. 医生: 有稽留热,如肺炎、猩红热、和斑疹伤寒;弛张热如伤寒;脓毒 性热和间歇热如疟疾。 Patient: What kind of fever is my temperature? 病人: 我的体温属于哪—种? Doctor: It may be continuous fever. Flue is also continuous fever. We shall give you an injection of penicillin and some medicine which will lower the fever. It should bring your fever down. 医生: 是稽留热,流感通常是持续性发热。我们要给你注射青霉素和口 服一些退烧药,你的体温会降下来的。 Nurse student: Will his temperature come down by lysis? 护士生: 他的体温是渐退的吗? Doctor: Yes,it will soon be subnormal after treating with medicine. 医生: 是的,用了药后会很快降到正常。 22 Nurse: Here is your medicine(Take one tablet three times daily after meal. Swallow them with a little boiled water. 护士: 这是你的药,1天3次,1次1片,饭后服。用些开水将这些药 吞下去。 Doctor: Thank you( 医生: 谢谢您。 Patient: Don't mention it(You should have a good rest. Good-bye. 病人: 不客气,你要好好休息,再见。 (After two days) (2天以后) Doctor: Are you feeling any better today? 医生: 今天你感觉如何? Patient: Much better ,thanks,although I still feel rather weak. 病人: 很好,谢谢,不过我还觉得很虚弱。 Doctor: What’s your temperature now? 医生: 现在你的体温怎样? Patient: My temperature has gone down to 37 degrees today( 病人: 今天我的体温已恢复到37?。 Doctor: Hm,we should also continue the therapy until your WBC is normal( 医生: 我们还继续治疗,直至白细胞正常。 Patient: May I eat all the different kinds of food 1 want? 病人: 我可以吃我想吃的各种食物吗? Doctor: No(Some kinds of food are not easily digested for you(Orangeades, soya milk,milk,porcine liver and kidney are nourishing food(They are easily digested and contain protein and vitamins( 医生: 不行。有些食物是不易消化的。橘子汁、豆奶和牛奶,猪肝和腰 子都是有营养的食品,这些食品容易消化,并含有大量的蛋白质 和维生素。 Patient: I see(What else should I do? 病人: 我明白了。我还应该做些什么? Doctor: You should take your temperature every day,until it is normal all the time( 医生: 你还应该每天测量体温,直至完全正常。 Patient: All right,thank you,doctor(I will do it( 病人: 好的,谢谢大夫,我一定这样做。 Doctor: Well(Good-bye(Get well soon( 医生: 好,再见,祝你早日健康。 142(采血和注射 Blood Taking and Injection Nurse: (1) I’ll take some blood from your arm(Please take off your coat and roll up your sleeve( 护士: 我要从你的手臂上取点血。请脱掉外衣,卷起袖子。 23 (2) I’ll take some blood from your ear(Please take off your ear ring( 我要从你的耳朵上取点血。请摘下你的耳环。 (3)Your veins don't stand out very clearly(I'll try to do it carefully(Be patient(Please clench your fist( 你的静脉不明显,我需要仔细找找。请耐心些。请你握拳。 (4)Please open your hand(Press it with this bit of cotton wool for a while( 请张开手,用这块棉团压一会儿。 (5)I'll do a skin test first to see if you have any sensitivity( 我要先给你做一个皮肤试验看看你有无过敏现象。 (6)Since you are sensitive to the anti-tetanus serum,we will have to give it to you in four doses(at an interval 0f twenty minutes( 由于你对破伤风毒素过敏,我们要分四次注射,每次相隔20分钟。 Patient: How often should I have the injection? 病人: 这针多久注射一次? Nurse: Once a day(Twice a day)( 护士: 每天一次(每天两次)。 Patient: Where do you give it? 病人: 在哪个部位注射呢? Nurse: In the buttocks(In the arms)( 护士: 在臀部(在手臂上)。 * * * Patient: I discovered a lump on my buttock yesterday(What shall I do? 病人: 我昨天发现我的臀部有个硬块。该怎么办呢? Nurse: Let me have a look(Better put hot towels on it(Twice a day for fifteen minutes(If it doesn't get better,we'll try physiotherapy( 护士: 让我看一下。最好用热手巾敷。一天敷两次,每次15分钟。假若不 见好,我们可以做理疗。 143(给氧 Oxygen Delivery (Professor Chang is giving a lesson in oxygen therapy to a class of medical students(His lecture is nearly completed() (常教授正在为医学生们讲授氧疗课,他的讲座已快结束。) Prof(Chang:„In short,oxygen is one of the most frequently ordered drugs for patients with a variety of disorders(Therefore,oxygen delivery is worth your much attention(Is there any question? 常教授: „„总之,对多种疾病的病人来说,氧气是最常用的药物之一。 所以你们对给氧应给予足够的重视。有什么问题吗? Student A: Why should low-flow oxygen administration be applied to patients with chronic lung disease? 学生甲: 为什么治疗慢性肺疾患患者必须用低流量给氧? Prof(Chang:A good question! Those patients usually have chronic retention,and 24 they rely more on the hypoxemia stimulus to breathe whereas normal people utilize the C0 mediated one(Too much oxygen may remove 2 the hypoxic drive( 常教授: 问得好!这些病人通常都有C0滞留,正常人靠C02刺激呼吸,而2 他们则更多地靠低氧血症来刺激呼吸,过多地给氧可能会消除这 种低氧刺激。 Student B: It seems that all drugs have some kind of side effects(Does oxygen follow the same rule? 学生乙: 所有的药物似乎都有副作用,氧气也有吗? Prof.Chang: Certainly(Abuse of oxygen may cause hypoventilation and resorption atelectasis. So you should keep in your mind the dictum“Use the least oxygen to gain acceptable goal”( 常教授: 当然。氧气滥用有可能导致肺换气不足与吸收性肺不张,所以请记 住这句格言“用最少的氧气达到可接受的目标”。 Student C: Then,how should oxygen administration be monitored? 学生丙: 那么,给氧该如何监测呢? Prof. Chang:Thanks to the advances in medical sciences. Oxygen delivery is no longer empirical. Arterial blood gas analysis helps doctors to be more scientific in oxygen delivery( 常教授: 由于医学科学的进步,给氧已不再是经验性的,动脉血气分析使得 医生在氧疗中能做得更科学。 Prof.Chang:Any more question ? Now Sister Li is going to give you a demonstration of oxygen administration( 常教授: 还有问题吗?下面李护士长将为大家做给氧示范。 (Sister Li demonstrated the procedures for oxygen delivery() (李护士长演示了给氧方法。) Student D: Sister Li(How shall we decide the proper depth a nasal cannula is to be inserted? 学生丁: 李护士长,鼻导管进入的深度怎么确定呢? Sister Li: The distance from nose to ear is usually considered as a proper indication of depth a nasal cannula should enter( 李护士: 通常认为耳鼻间距是鼻导管插入深度的一适宜指标。 (The bell is ringing) (铃声响了) Prof(Chang:That's all for today(If you have further questions,1 will be glad to discuss them with you after class( 常教授: 今天的课就讲到这里。如果你还有什么问题,课后我将非常乐意 与你讨论。 144(监护室 Intensive Care Unit Nurse: Dr(Wang,the condition of that patient is very poor(He's so excited, I can't quiet him down( 25 护士: 王医生,那个病人情况不好。他躁动得厉害。我难于使他安静下来。 Doctor: I'm afraid he will be in a state of shock(It's necessary to take his pulse,respiratory rate and blood pressure regularly( 医生: 恐怕他进入早期休克了,要定期测量他的脉搏、呼吸和血压。 Nurse: All right(I'll take them every hour( 护士: 好,我每小时测一次。 Doctor: No,you'd better take them half an hour( 不,最好半小时测一次。 医生: Nurse: His blood pressure is 86,50mmHg and he has rapid pulse and respiratory rate( 护士: 他的血压86,50mmHg,脉搏及呼吸加速。 Doctor: Place the patient in the head-low position. Elevate the foot 0f the be(L Put hot water bottles around him(Telephone to the blood bank t0 ask whether there is blood available for this patient(His blood is type O. I’ll give him a blood transfusion( 医生: 将病人置于头低位,抬高床腿。患者身旁放些热水袋。打电话问 一下血库有没有合适的血,他是O型血。我准备给他输血。 Nurse: What if there is no type O blood available for him? 护士: 如果没有0型血怎么办? Doctor: In that case,please tell the patient's relatives t0 donate blood to him. 医生: 若那样,就通知病人亲属给他献血。 Nurse: Is oxygen given? 护士: 吸氧吗? Doctor: Yes,of course(The patient's condition is very critical and his life is in danger, but we'll do everything possible to save him(Nurse,please get the emergency drugs ready as soon as possible( 医生: 当然要吸氧。患者病情危重,有死亡的危险。我们要尽一切努力 抢救他。护士,请尽快把急救药品准备好。 Nurse: All right,I'll do so(What else? 护士: 好,我会照办的。还有其他吩咐吗? Doctor: You'd better arrange special nursing care for him. 医生: 最好给他安排个特护。 Nurse: It is what 1 want to say( 护士: 我也是这个意思。 Doctor: You should notice whether the patient is conscious 0r not and change 0t ins pupils, recording the volume of urine and other fluid in or out of his body accurately( 医生: 你们要注意观察病人的意识状态和瞳孔变化,准确记录尿量及其他 液体出入量。 Nurse: I'll do it well( 护士: 我会干好的。 Doctor: Keeping his respiratory tract through,abstracting sputa from airway regularly, measuring his blood pressure in time,especially after 26 noradrenaline or dopamin is given( 医生: 保持呼吸道通畅,定时吸痰,及时测量血压,特别是在用去甲肾上 腺素或多巴胺后尤其注意监测。 Nurse: We’11 clean his oral cavity twice a day and his eyes once a day. 护士: 我们每天做两次口腔清洁护理和一次眼部护理。 Doctor: It is skin that is the most important thing(You manage to protect him from bedsore occurring(Besides these,we should maintain the balance of three kind of nourishing elements,water and electrolytes in his body(There are a lot 0f things for us to do( 医生: 最重要的是皮肤,你们要设法防止发生褥疮。此外,要维持病人体 内的三大养素和 水电解质平衡。要做的事多着呢。 Nurse: Hope he would come soon( 护士: 希望他会很快醒来。 145(配膳室 Diet Preoaration Room Medical student:Do all the patients in the hospital take the same diet? 医学生: 医院内的病员都吃一样的饮食吗? Doctor: No,certain diseases have special diets( 医生: 不,有些病就吃特别饮食。 Medical student:What diet is given to the patients that are almost well? 医学生: 快要痊愈的病人吃什么饮食? Doctor: They have full or regular diet( 医生: 他们可以吃普通饮食。 Medical student:What diet is given to those who can't get out of bed? 医学生: 不能起床的病人该给他们吃什么? Doctor: They are usually given soft diet( 医生: 通常给他们吃软食。 Medical student:What diet is given to those who are very ill? 医学生: 给病重的病人吃什么饮食? Doctor: They have fluid diet or a special diet( 医生: 给他们流质或特别饮食。 Medical student:How many times a day do we give the patient special nourishment? 医学生: 一天给病人几次特别营养饮食? Doctor: Generally the patient have an additional snack at 10 a m,3 p(m and 8 p(m( 医生: 大概在上午10点,下午3点及8点钟给病人各增加1次点心。 Medical student:What could we do if a patient could not take his food by mouth? 医学生: 病人不能口进食怎么办? Doctor: We might use enteral nutrition support through a nasal tube otherwise we might give parenteral nutritional support( 医生: 可以通过鼻导管经肠营养,不然可用静脉营养。 Medical student:In what condition do we select enteral or parenteral nutrition 27 support? 医学生: 在什么情况下选用经肠营养或是经静脉营养。 Doctor: Enteral nutrition support is indicated for any patient requiring nutritional support who has a fully or partially functional gastrointestinal tract(But who can't take in the required energy by mouth(The commonest indication is disorder of mouth,throat or esophagus,unconsciousness including cerebrovascular accidents。 head trauma or postoperative patients and severe burns(For those whose gastrointestinal function fail or can't be fed by nasal tube,we prefer parenteral nutrition support( 医生: 那些有良好或部分胃肠道功能,需要营养辅助,但是不能经口 摄入需要的能量的病人,适于应用经肠道营养。常见的适应证 是口、咽或食管有疾病,昏迷病人包括脑血管意外,头颅外伤 或术后病人及烧伤严重病人。胃肠功能不好或不能鼻饲的病人 最好用静脉营养补充。 Medical student:What's the advantage of enteral tube feeding? 医学生: 经肠管饲的优点是什么? Doctor: Enteral nutritional support is more physiological(Enteral solutions arc more nearly nutritionally complete(It is more safe and economical( 医生: 经肠补充营养较合乎生理,用的溶液在营养上亦较完善,较为 安全及经济。 Medical student:Are there any contraindications for enteral tube feeding? 医学生: 经肠道管饲有无禁忌证? Doctor: Yes.Those who suffer from intractable vomiting,or intestinal obstruction,or paralytic ileus,or absent cough reflex are not indicated( 医生: 对那些患有顽固性呕吐,或有肠梗阻,或麻痹性肠梗阻或没有 咳嗽反射的病人均不适宜。 Medical student:How to manage the enteral tube feeding? 医学生: 如何施行经肠道管饲? Doctor: The tube should preferably be introduced to the duodenum in unconscious and postoperative patients and those to be fed continuously over 24h,and to the stomach for all others. Continuous drip feeding over 24h per day or 16h per day must be given( 医生: 对昏迷及术后病人及需要24小时连续灌注的病人最好将管子放 人十二指肠内,其他病人亦可放在胃内。应该每天连续灌注24 小时或16小时。 Medical student:What are to be fed? 医学生: 管饲些什么? Doctor: Ordinarily the liquid formular diet is used,but we prefer elemental diet which are ideal especially for gastrointestinal problems such as 28 distal fistula and malabsorption(They are absorbed in the intestines not requiring digestion( 医生: 一般常用流质配方膳,但最好用要素膳,尤其对胃肠远端有瘘 管及吸收不良病人,素膳不需消化就在肠道吸收。 146(挂号 Registration Do you want to see a doctor? Nurse: 护士: 你要看病吗? Patient: Yes,where shall I register? 病人: 是的,在哪儿挂号? Nurse: Here,have you been here before? 护士: 这儿,你从前来过吗? Patient: Yes,a year ago( (No,this is my first visit() 病人: 是的,一年前来过。 (没有,这是第一次来。) Nurse: Have you a registration card? 护士: 你有挂号证吗? Patient: Yes,here it is( (No,I forgot to bring it() 病人: 有,在这儿呢。 (没有,我忘记带了。) Nurse: Do you remember your card number? 护士: 你记得你的挂号证号码吗? Patient: Yes,it is C dash one,five,zero,eight,four,three( 病人: 记得,是C-150843。 Nurse: When did you come last? 护士: 上次你什么时候来的? Patient: About a week ago( 病人: 大约在一周以前。 Nurse: Then I'll find out for you( 护士: 那么,我给你查查。 Nurse: Are you working in the Embassy? 护士: 你在大使馆工作吗? Patient: Yes,I'll be here for three to five years( 病人: 是的,我要在这儿呆三至五年。 Patient: I'm a teacher at„ 病人: 我是„„的教师。 Nurse: Please show me your identity card(diplomatic certificate,experts certificate, passport)( 护士: 请出示你的身份证(外交官证、专家证、护照)。 Patient: I'm a tourist( 29 病人: 我是一个旅游者。 Nurse: How long do you intend to stay here? 护士: 你准备在这里呆多久? Patient: (1)About one week( 病人: 大约一周。 (2)Till the end of this year( 到今年年底。 (3)I'm leaving tomorrow morning( 我明天早晨就走。 Nurse: (1)I'll make a file(record)for you u( 护士: 我要给你做一份病历。 (2)Please write down your full name in block letters( 请用印刷体写上你的全名。 (3)How old are you? 你的年龄? (4)When were you born? 你是哪年生的? Patient: 1 was born on the fifteenth of February nineteen fifty two( 病人: 我是1952年2月15日生的。 Nurse: What is your position in the Embassy? 护士: 你在大使馆做什么工作? Patient: I'm the ambassador(minister,charge d,affaires,counsellor,first secretary,second secretary,third secretary,attach6,staff, secretary-archivist,military attache)( 病人: 我是大使(公使,代办,参赞,一等秘书,二等秘书,三等秘书,随 员,职员,档案秘书, 武官随员)。 Nurse: What is your work here? 护士: 你在这里做什么工作? Patient: I'm a delegate(businessman,engineer,teacher,artist,musician,retired worker, pilot,housewife)( 病人: 我是代表团团员(商人,工程师,教师,艺术家,音乐工作者,退休 工人,飞机驾驶员,主妇)。 Nurse: Are you married or single? 护士: 你结婚了,还是独身? Patient: (1)Yes,I'm married( 病人: 是的,我结婚了。 (2)No,I'm single( 没有,还是独身。 (3)I'm divorced( 离婚了。 Nurse: What's your address,please( 护士: 请告诉我你的地址。 Patient: I live in„hotel(„Embassy,„building(((block„number)( 30 病人: 我住在„„饭店(„„使馆,„„单元„„楼„„号)。 Nurse: Your telephone number,please( 护士: 请告诉我你的电话。 Patient: Five,two,two,one,three,three(Extension one five six( 病人: 522133,分机156。 Nurse: This is your registration card(Please don't lose it and bring it whenever you come. 护士: 这是你的挂号证。请不要遗失。每次来时带着它。 Patient: Yes,1 will( 病人: 好,照办。 * * * Nurse: (1) What's wrong with you today? 护士: 你今天哪里不舒服? (2)Which department do you want to register with? 你要挂哪科的号? Patient: 1 want to see a physician(an internist,surgeon,obstetrician, gynaecologist,pediatrician,neurologist,dermatologist,oculist, E(N(T(,specialist,traditional medicine doctor,allergist,urologist, orthopedist,dentist,endocrinologist)( 疯人: 我要看病(内科,外科,产科,妇科,小儿科,神经科,皮肤科,眼 科,耳鼻喉科,中医科,过敏反应科,泌尿科,骨科,牙科,内分 泌科)。 Patient: I don't know which clinic(I have rash all over my body(It itches badly( 疯人: 我不知道该挂哪个科。我浑身起红疹。痒得厉害。 Nurse: I think you should see a dermatologist first(If necessary we'll transfer you t0 the physician( 护士: 我想你应当先看皮肤科大夫。需要的话再转诊。 * * * Parent: My daughter has had diarrhea since yesterday and keeps on vomiting(1 would like her to see a pediatrician( 家长: 我女儿从昨天开始腹泻而且总吐。我想让她看看儿科医生。 Nurse: (1)Please take her temperature under her arm( 护士: 请给她试试腋温。 (2)We would like to have her stool examined(Will you please give us a specimen? 我们想给她检查一下大便。你能给我们一点大便标本吗? Parent: Yes,I'll try( No,I don't think she can pass any stool just now,but I have brought her diaper with me,maybe you can get some from the diaper( 家长: 可以,我试试看。 不行,我想她现在便不出来。但是我已经把她的尿布带来了,或者 你们可以从尿布上取点大便。 * * * 31 Patient: 1 would like to see a dentist( 病人: 我想见一位牙科医生。 Nurse: For a filling?A denture?Or a cleaning? 护士: 补牙?镶牙(作义齿)?还是洗牙(洁齿)? Patient: 1 want to have a denture fitted(my teeth cleansed),please make an appointment for me( 病人: 我要镶牙(洁齿),请给我约个时间。 OK! Next Wednesday,do you prefer 8 o'clock or 10 o’clock(。 Nurse: 护士: 好吧!下星期三,你愿意上午八点钟还是十点钟来? Patient: Ten o'clock suits me better( 病人: 十点钟对我更合适些。 147(住院 Admission (1) Nurse: Sir,have you registered? 护士: 先生,你办住院手续了吗? Patient: No,I have not registered( 病人: 没有,我还没有办理。 Nurse: Are you a medical or surgical case? 护士: 你是内科还是外科病人? Patient: I'm a medical case( 病人: 我是内科病人。 Nurse: Do you have your history sheet? 护士: 你有病历单吗? Patient: Yes,here you are( 病人: 有,给你。 Nurse: Please,fill this admission card( 护士: 请填住院卡。 Patient: Oh,let me see„(It is finished now( 病人: 嗯,让我看一下,„„填好了。 Nurse: How long do you expect to stay in the hospital( 护士: 你准备在医院住多久? Patient: The doctor told me to stay about one month(I have nephritis(This is the second time to enter the hospital( 病人: 医生告诉我大概住一个月,我患肾炎,这是第二次住院了。 Nurse: Would you come to the hospital today? 护士: 你今天就来住院吗? Patient: Yes,I hope to enter the hospital this morning( 病人: 是的,我希望今天上午就住院。 Nurse: But,there is no bed available now(This afternoon,two patients will be discharged so you may be admitted this afternoon( 护士: 可是现在没有空床,今天下午有2个病人出院,下午你可以来住院。 32 Patient: Well,when they leave the hospital,I shall admit(How many beds are there in this hospital? 病人: 好的,他们一出院我就住进来。这个医院有多少床位? Nurse: There are five hundred and eighty beds. 护士: 有580张床。 Patient: What are the visiting hours? 病人: 什么时候探视? The visiting hours are from 3 o'clock to 5 o'clock p(m,on Monday,Nurse: Wednesday。 Friday,and from 8-12 a(m(and 3-5 p(m(on Sunday( 护士: 星期一、三、五的下午3点到5点。星期日上午8,12点,下午3, 5点。 Patient: Thank you for introducing these information(Good-bye( 疯人: 谢谢你的介绍,再见。 Nurse: Good-bye(See you in the afternoon( 护士: 再见,下午见。 (In the afternoon) (当日下午) Patient: Good afternoon,nurse(Are there bed available now? 疯人: 你好,护士小姐,现在有空床了吧? Nurse: Good afternoon,two patients have been discharged this afternoon(You may admitted to the medical ward( 护士: 你好,下午两个病人已经出院了,你可以住进内科病房了。 Patient: Thank you very much( 病人: 太感谢你了。 Nurse: Don't mention it(Have you registered? 护士: 不客气,你已经办手续了吧? Patient: Yes,I have registered this morning( 疯人: 是的,今天上午我已经办好手续了。 Nurse: You are admitted at 3 P(M( 护士: 你是今天下午3点钟住院。 Patient: Which ward do I go to? 疯人: 我住到哪个病房? Nurse: You are a medical case and should go to the medical ward on the second floor( 护士: 你是内科病人,到二楼内科病房。 Patient: Are there line,bedding and clothing in the ward7 病人: 病房里有褥单、床单及衣服吧? Nurse: Yes,but our patients bring their own towels( 护士: 有,但我们的病人应带他们自己的毛巾。 Patient: Where should the patient's own clothing be kept? 疯人: 那么病人自己的衣服存放何处? Nurse: The hospital has a cabinet with lockers in which to keep the patient's clothing( 33 护士: 医院内备有带锁的衣柜,可以放置病人的衣服。 Patient: Where are the patient's valuables kept? 病人: 病人贵重的东西放在哪里? Nurse: They should be given to the Head Nurse who will lock them up in a safe place( 护士: 可以交给护士长,锁在安全的地方。 Patient: That's very good( 那太好了。 病人: Nurse: Well,please follow me,let's go to your ward( 护士: 好,请跟我来,我们去您住的病房。 (2) Nurse: How do you do?Welcome(I'm the nurse in charge of this ward(We hope you will feel at home here(This is nurse Wang(Here is your doctor, Doctor Chen( 护士: 你好。欢迎你。我是这病房的护士长。希望你在这里像在家里一样。 这位是王护士,这是负责你的医生,陈医生。 Patient: Sorry to bother you a11( 病人: 麻烦你们大家了。 Nurse: If you need anything,just press this button( 护士: 你若需要什么,就请按这只电钮。 Patient: Is it possible for my sister to stay here with me? 病人: 我姐姐可以在这里陪我吗? Nurse: (1)Yes,but she has to pay for her bed(Does she want to have meals here too? (2)We don't think it is necessary(Your condition isn't so serious( 护士: (1)可以,但是得交陪住费,她也在这里用饭吗? (2)我们想不需要。你的病情不那么严重。 Patient: What are the hours here for meals? 病人: 这儿什么时候开饭? Nurse: Patients usually get up at 7 A(M(Breakfast is at 8 o'clock(The ward rounds and treatment start at 9 A(M(Lunch at noon(After that you have a nap or rest(Visiting hours are from 3-7 P(M(Supper is at 6 P(M(Bed time is from 9"30-10:00 P(M( 护士: 病人一般早7点起床。8点吃早餐。9点医生查房和做治疗。12点午 餐。饭后午睡或休息。下午3点到7点是探视时间。6点晚餐。9点 半到10点病人该睡慌了。 Patient: Will you show me where the sitting-room,bathroom and telephone are? 病人: 请告诉我起坐间,浴室和电话在哪儿好吗? Nurse: Of course(Are you Muslim? 护士: 当然可以。你是伊斯兰教徒吗? Patient: Yes,I am( 病人: 是,我是。 Patient: No,I am not( 34 病人: 不,我不是。 Nurse: Which kind of food do you prefer。Chinese or Western? 护士: 你喜欢吃中餐还是喜欢吃西餐? Patient: I prefer Western food( 病人: 我愿意吃西餐。 Patient: 1 like Chinese food very much( 病人: 我非常喜欢吃中餐。 Have you eaten breakfast(1unch,supper)already? Nurse: 护士: 你吃过早饭(午饭、晚饭)了吗? Patient: Yes,I have( 病人: 是,吃过了。 Patient: No,I have not( 病人: 没有,还没吃。 Nurse: How is your appetite? 护士: 你的胃口怎样? Patient: (1)Not so good( 病人: 不太好。 (2)Just so so( 一般。 (3)I have no appetite at a11( 一点食欲都没有。 Nurse: What are your eating habits? 护士: 你的饮食习惯怎么样? Patient: (1)I don't eat much(1 would like to have a snack in the afternoon and before going to bed( 病人: 我吃得不多。我希望在下午和睡前吃点东西。 (2)I don't like greasy food( 我不喜欢吃油腻的东西。 (3)I prefer more vegetables to meat( 我愿意多吃青菜,少吃肉类。 (4)Since I am overweight,I only take fish and chicken( 由于我现在太胖了,所以我只吃鱼和鸡。 (5)I don't like sweet things( 我不喜欢甜食。 Nurse: Are you allergic to certain food like prawns or shrimps? 护士: 你对某些食物有过敏情况吗?如对虾、小虾。 Patient: I am allergic to sea food( 病人: 我对所有海产食物都过敏。 Nurse: Do you like fruit? 护士: 你喜欢水果吗? Patient: Yes,please give me some with each meal( 病人: 是的,请每餐都给我些水果。 Nurse: (1)Do you prefer a consomme or a cream soup? 35 护士: 你喜欢清汤还是奶油汤? (2)Do you prefer milk or sour milk? 你喜欢牛奶还是酸奶? (3)Do you prefer black tea,jasmine tea,0r coffee? 你喜欢红茶、茉莉花茶还是咖啡? (4)Do you take sugar with your milk(tea,coffee)? 你的奶(茶、咖啡)里放糖吗? (5)Do you like our eggs soft-boiled,hard-boiled or fried? 你要煮嫩蛋、老蛋还是煎蛋? Patient: (1)I like rice gruel(porridge,noodles,toast)( 病人: 我喜欢大米粥(稀饭、面条、烤面包)。 (2)Please give me some fruit juice(ice water,mineral water)( 请给我一些果子汁(冰水、矿泉水)。 (3)Please don't give me any cakes(I only want soda-crackers( 请不要给我蛋糕,我只吃苏打饼干。 (4)Since my teeth are bad,please give me soft foods and tender meat( 因为我牙齿不好,请给我软的食品和嫩的肉。 Nurse: Please try to eat a little more(It will help you recover more quickly( 护士: 请多吃一些。这样可以帮助您早日康复。 148(探视病人 Visiting a Patient (Miss Qi has been admitted to hospital for peptic ulcer(Her friend,Mr(Wang,is coming to visit her() (齐小姐因消化性溃疡住进了一家医院。此刻,她的朋友王先生来医院探望她。) Mr(Wang:Good afternoon,Miss Qi( 王先生: 齐小姐,下午好。 Miss Qi: Good afternoon(It's very nice to see you again( 齐小姐: 下午好。真高兴又见到你了。 Mr(Wang:How are you feeling today? 王先生: 你今天感觉怎么样? Miss Qi: I am much better(The stomachache is gone,and the doctor is about to give me another endoscope examination to see whether the ulcer do heal up( 齐小姐: 好多了。胃痛已消失,医生打算再做一次内窥镜检查,看看溃疡是 否真的愈合了。 Mr(Wang: Did you ever have this disease before? 王先生: 你以前患过这病吗? Miss Qi: Yes.The disease was first discovered three years ago(I have suffered much from its periodical recurrence in the last three vears( 齐小姐: 是的,三年前第一次发现有该病。过去三年中,它反复发作,给我 带来了很大的痛苦。 Mr.Wang: You had been working too hard before your hospitalization.This might 36 be one of the reasons for this most recent recurrence( 王先生: 住院前,你工作太刻苦了,这也许是此次发作的原因之一。 Miss Qi: Maybe you are right( 齐小姐: 也许是这样吧。 Wang: Here are something for you(I hope you will like them( Mr( 王先生: 这些是给你,希望你能喜欢。 Miss Qi: How beautiful those flowers are!I like them very much.Indeed’orange’ the kind of fruit I like most(Unfortunately,the doctor has advised me to take no acid food(Thank you for your kindness anyway. 齐小姐: 好美的花啊!我很喜欢。的确,橘子也正是我钟爱的水果。不幸的 是,医生建议我不要进食酸性食物。不管怎么样,谢谢你的好意。 Mr(Wang: I also bring some magazines for you(1 wish that they may help you to overcome the tedium you'll have in hospital( 王先生: 我还给你带来了些杂志,希望他们能帮你克服住院期间可能会有的 单调乏味感。 Miss Qi: You are so considerate! 齐小姐: 你想的太周到了。 Mr(Wang: It’s time for me to leave(Several of our colleagues have come together. They are waiting for my return so that they could come in to see you. 王先生: 我该走了。我们几个同事一起来的,他们正等着我回去,这样他们 才能进来看你。 Miss Qi: But why don't you come in together? 齐小姐: 你们为什么不一起进来呢? Mr(Wang:The hospital has the regulation that only one person may enter each time. 王先生: 医院有规定,一次只能进来一个人。 Miss Qi: I see( 齐小姐: 我明白了。 M r(Wang:See you later(I hope that you will recover soon( 王先生: 再见。祝你早日康复。 Miss Qi: Thank you for coming(Good-bye( 齐小姐: 谢谢你来看我,再见。 149(出院 Discharge (1) Doctor: Good morning,Sir(How are you feeling today? 医生: 早上好,先生,今天觉得怎么样? Patient: Fine,thanks(I feel all my trouble has gone(Can I leave the hospital within this week? 病人: 不错,谢谢。我觉得没有什么不适了。这周我能出院吗? Doctor: You've gotten an ideal recovery after operation as expected(So don't think it's unpractical that you leave the hospital the day after tomorrow( 37 医生: 你术后恢复的很顺利,我看后天出院没什么问题。 Patient: Do you think I can return to my original occupation very soon? 病人: 你看我可以马上恢复工作吗? Doctor: Don't so hurry( 不要这么急。 医生: Patient: How long do you think before I can return to my work? 病人: 你看我还要等多长时间? Doctor: I can assure you'll fully recover after four to six weeks( 医生: 我相信四到六周后你会完全恢复的。 Patient: Is there anything I should follow? 病人: 有什么要注意的吗? Doctor: You'd better have a good rest for one week( 医生: 你还是该好好休息一周。 Patient: You mean I should stay in bed for the whole week! 病人: 你是说我要在床上躺整整一周。 Doctor: No,you should get outdoors more and get some exercises( 医生: 不是,你还是该到室外多活动活动。 Patient: What should I do first? 病人: 开始我该怎么做? 。 Doctor: Anything you like,such as taking a walk or having a breath in morning( 医生: 随你喜欢,比如早晨散散步,呼吸一些新鲜空气。 Patient: What kind of food should I have,special nourishment? 病人: 我该吃些特殊营养食物吗? Doctor: Have regular meals first(Keep to a diet of vegetable and fruit(Keep off alcoholl。If possible,give up smoking,at least for a time( 医生: 首先饮食要规律,多吃蔬菜、水果,别喝酒,如果可能,也别抽烟, 至少最近别抽。 Patient: Should I take some medicine? 病人: 我还要吃药吗? Doctor: Yes,I am going to give you some and you've got to take every day(Now,I'll write a prescription for you( 医生: 当然,我这就给你开一些,坚持每天吃。这是处方。 Patient: When will these tablets be finished? 病人: 这些药多长时间吃完? Doctor: In three days,and then you may come back and get some more( 医生: 3天。以后再来拿一些。 Patient: How should they be taken? 病人: 怎么服? Doctor: Take one tablet of this medicine three times a day before meals)that one, two tablets twice a day( 医生: 这种药每天3次,饭前每次1片;这种药每日2次,每次2片。 Patient: I see,thank you( 病人: 知道了,谢谢你。 38 Doctor: Remember to come to out-patient department for a consultation two weeks later,please( 医生: 记着两周后到门诊来复查。 Patient: At your disposal( 病人: 听你的。 Doctor: By the way,you have to return the utensils in order to get your money back( 医生: 顺便提一下,你要把病房用具还回去才可拿回押金。 Patient: Well,1 will( 病人: 好,我会的。 Doctor: You can settle the accounts tomorrow( 医生: 你明天就可以结账。 Patient: All right(My wife is outside(Would you please ask her to come in so I an make some necessary arrangements for leaving hospital( 病人: 好吧,我妻子在外面,请您叫她进来。我们做些出院准备。 Doctor: 0f course( 医生: 当然可以。 Patient: It's very kind of you( 病人: 非常感谢。 Doctor: You are welcome(Wish you an early recovery(Good-bye( 医生: 别客气。祝你早日康复,再见。 (2) Nurse: You have been in the hospital for two weeks,haven't you? 护士: 你住院两个星期了,是吧? Patient: Exactly,but the doctor told me I still have t0 rest for one more week( 病人: 对的,可是医生说我还得休息一个星期。 Nurse: The doctor has written a certificate for you(There are two suggestions(First,avoid any mental stress and have a good rest(Secondly。examinations of fasting sugar and an EKG should be done regularly( 护士: 医生已经给你开好了证明书。里面有两个建议。第一,避免精神紧 张,好好休息。第二,定期查空腹血糖和做心电图检查。 Patient: My family doctor needs my medical history(May I have it tomorrow? 病人: 我的家庭医生需要我的病史,明天能给我吗? Nurse: Certainly( 护士: 当然可以。 Patient: Please give me my account( 病人: 请给我结一下账。 Nurse: I'll go to the admissions,office to get your bill at once( 护士: 我立即到住院处去给你结账。 Patient: How much do 1 owe you ?May I pay it by cheque? 病人: 我欠多少钱?能用支票付款吗? Nurse: Altogether three hundred and fifty yuan,seventy five fen(You may pay 39 either in cash or by cheque( 护士: 总共350元7角5分,你付现金或开支票都行。 Patient: I must go now(Will you call a taxi for me? 病人: 我该走了。请给我叫辆出租汽车,好吗? Nurse: Have you made sure you haven't left anything behind? 护士: 你没有遗留下什么东西吗? Patient: I don't think so(I'm really very grateful to you a11(You were all so kind to me( 病人: 我想没有。我十分感谢你们大家。你们对我都这么好。 Nurse: Don't mention it(That is our job( 护士: 不必客气,那是我们的职责。 Nurse: The taxi has come( 护士: 出租车来了。 150(医务人员常用语 Sentences Commonly Used by Medical Personnel 1(What can I do for you? 你有什么事? 2(May I help you? 我能帮你什么忙吗? 3(Please take a seat! Please sit down! 请坐下! 4(Wait a moment,please( 请等一等。 5(Sorry to have kept you waiting( 对不起让你久等了。 6(It is not serious( 病情不严重。 7(Don't worry( There is nothing to worry about( 不必顾虑。 8(You need a thorough examination( 你需要做一个全面检查。 9(Let me take a look in your ears,first( 首先,让我看一下你的耳朵。 10(Now let me examine your nose( 现在让我检查你的鼻子。 11(Look right at me,please( 请看着我。 1 2(Now open your mouth( 现在张开你的嘴。 13(Open it just as wide as you can( 40 尽量把嘴张大。 14 I'm not going to do anything to hurt you( 我不会使你感到疼痛。 15(Lift your tongue up to the roof of your mouth( 把你的舌头抬到上腭。 16(Now let your tongue down( 现在把你的舌头放下来。 1 7(Just breathe easily through your mouth( 只用嘴轻轻地呼吸。 18(Please say。“Ah”( 请说“啊”。 19(Now 1 want to look in your throat with my mirror( 现在我要用喉镜检查你的咽喉。 20(Would you come toward me just a little? 稍向我靠近一点好吗? 21(Stick your tongue out( 把你的舌头伸出来。 22(Would you please lower your slip? 请把你的衬衣往下拉一拉好吗? 23(That's it(Sit up nice and straight( 就这样。坐好,坐直。 24(Now put your arms on your hips( 现在把你的手臂放在髋部。 25(Now overhead( 现在举在头上。 26(Now rest your arm on mine( 现在把你的手臂放在我的手臂上。 27(1 just want to feel under your arm( 我只需要在你腋下摸一摸。 28(Now the other one( 现在请换另一侧。 29(Now would you please lie down? 现在请你躺下好吗? 30。Let’s put this pillow under your right shoulder( 让我们把这个枕头放在你的右肩下。 3 1(Now put your right arm(over your head( 现在把你的右臂放在你的头上。 32(Now,let's do the same on the left( 好啦,让我们在左侧同样做一次。 33(Now,that wasn't too painful,was it? 嗯,不太痛,是吗? 34(Is the condition serious? 病情严重吗? 41 35(That’s something we are going to discuss now( 这就是我们现在要讨论的问题。 36(We need lust a little more information( 我们需要了解更多一些情况。 Have you had any fever? 37( 你发热了吗? 38(Point with your finger where it hurts the most 用手指指出最痛点在什么部位。 39(Does it hurt you when you move? 活动时痛吗? 40(Does it help if you lie still? 如果你躺着不动,疼痛能缓解吗? 41(Have you had a cold recently? 你最近患过感冒吗? 42(Have you been with anyone who has a cold? 你与患感冒的人接触过吗? 43(Have you been coughing lately? 最近你咳嗽吗? 44(Have you been short of breath at all? 你是否有过气短? 45(Do you have any burning about an hour after meals? 你在饭后一小时左右感到烧心吗? 46(Please take your clothes off and put this sheet over you( 请脱下你的衣服,盖上被单。 47(I'm finished with the physical exam( 我做完了体格检查。 48(Do you suffer from heartburn stomachaches(100se bowel movements,chest pains)? 你的胃有过烧心感(稀便、胸痛)吗? 49(Do you want to have your tooth extracted(tooth filled,dressing changed,blood pressure checked)? 你要拔牙(补牙、换药、量血压)吗? 50(Let me examine you please( 我给你检查一下。 51(Please take off your shoes and lie down( 请脱鞋,躺下。 52(Please unbutton your shirt and loosen your belt( 请解开上衣的扣子,松开腰带。 53(Please take off your trousers( 请脱下裤子。 54(Please lie on your back(stomach,right side,left side)( 请仰卧(俯卧、右侧卧、左侧卧)。 55(Please bend your knees( 42 请屈膝。 56(Please relax( 请放松。 57(Please breathe deeply(normally)( 请深呼吸(正常呼吸)。 58(It's difficult to say just now exactly what's wrong( 现在还不好说是什么病。 59(Please Iet me feel your pulse( 让我摸摸你的脉搏。 60(Let me take your blood pressure( 我给你量一下血压。 61(Please lift your left leg(-right leg)( 请拾起你的左腿(右腿)。 62(If the trouble persists。come back again( 要是情况不好,请再来门诊。 63(It is normal(essentially normal)( 结果(基本)JE常。 64(Have you ever received any treatment before? 你以前治过吗? 65(Has it gotten worse? 情况变坏了吗? 66(Has it happened before? 这种情况以前发生过吗? 67(Are you feeling better? 你觉着好一些吗? 68(Is the pain getting less? 疼痛减轻些了吗? 69(Does it still hurt? 还疼吗? 70(How long have you had this pain? 你从什么时候开始有这种痛的? 7l. Has he ever had any heart trouble? 他得过心脏病吗? 72(Did he ever have rheumatic fever as a child? 他小时侯得过风湿热吗? 73(Did he ever have scarlet fever? 他得过猩红热吗? 74(I have his previous history here( 我这里有他的既往病史。 75(He's never been short of breath on exertion( 他在用力时从来没有气短过。 76(He's slept on one pillow an of his life( 他一直是枕一个枕头睡觉。 43 77(He's never had swelling of the ankles( 他从来没有踝部水肿。 78(He's never had to get up during the night to pass his water( 晚上他从不起来小便。 Is all that correct? 79( 以上说的全对吗? 80(Has he noticed any of these symptoms recently? 最近他注意到有这些症状吗? 81(Has he ever had any chest pain before? 以前他有过胸痛吗? 82(This is the first time( 这是第一次。 83(Is there any history of heart disease in his family? 他的家族成员中有心脏病史吗? 84(His father died of a heart attack( 他父亲死于心脏病。 85(So did his uncle( 他叔父也是死于心脏病。 86(He says he felt light-headed(Is that right? 他说他觉得头晕,对吗? 87(He didn't actually experience unconsciousness? 他实际上没有过不省人事吧? 88(I'll be back in a few minutes,and we'll examine him then( 我一会儿就回来,然后我们给他检查。 89(I'm inclined to agree with you( 我倾向于同意你的意见。 90(1 would hospitalize her( 我要收她住院治疗。 91(Get your blood work done( 你把血液检查做了。 92(Remember,do no vaginal examinations( 要记住,别做阴道检查。 93(The bleeding may not stop( 出血可能不会停止。 94(1 would examine her under a double setup in the OR( 我要在手术室有两种准备(输血与手术)的情况下给她做检查。 95(Do you have any other problems? 你还有别的问题吗? 96(No,there's nothing else right now( 没有,目前没有别的问题了。 97(I've just discussed her case with another doctor( 我刚与另一位医生讨论了她的病情。 98(The smart thing to do would be to come into the hospital( 44 最好是住院。 99(She should come in for a brief period of examination( 她应该住院做短期检查。 100(I'll go now and make the necessary arrangements for her admission( 现在我要去为她住院作必要的安排。 45
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