临床医学英语
Chapter 1 Patient-Physician Interaction Page 1
第一章 医患沟通 第1页
The patient-physician interaction proceeds through many phases of clinical
reasoning and decision making.
proceed 进行、开展 reasoning 推论、推理 clinical reasoning 诊断
clinical decision 确定治疗
making decision 做出决定
医患沟通在临床诊断和治疗决策的许多时期进行着。
The interaction begins with an elucidation of complaints or concerns,
followed by inquiries or evaluation to address these concerns in increasingly
precise ways.
elucidation 说明、阐明 inquire 询问、调查 evaluation 评估、评价
这种沟通开始于病人主诉或所关注问题的阐明,然后通过交流、评估不断精确地
确定这些问题。
The process commonly requires a careful history or physical examination
, ordering of diagnostic tests, integration of clinical findings with
the test results, understanding of the risks and benefits of the possible
courses of action, and careful consultation with the patient and family
to develop future plans.
integration 综合 consultation 磋商、会诊
这个过程通常需要细致的询问病史和体格检查,开具诊断性化验医嘱,综合临床
发现和化验结果,理解
拟行治疗过程中的风险和疗效,然后与病人及家属反
复磋商以完善治疗方案
Physicians increasingly can call on a growing literature of evidence-based
medicine to guide the process so that benefit is maximized, while respecting
individual variations among different patients
respecting 注意到、关系、说到 evidence-based medicine 循证医学
尽管考虑到不同病人中个体差异是存在的,但医生们越来越容易查阅不断增长的
循证医学文献来指导这个过程,使得疗效最大化。
The increasing availability of randomized trials to guide the approach
to diagnosis and therapy should not be equated with “cookbook” medicine
availability 可利用性, 可得到 randomize 随机的
cookbook 食谱,烹调书 approach 接近
但是,不断增加的可用于指导临床诊断与治疗的随机试验资料不应当作“烹调书”
使用。
Evidence and the guidelines that are derived from it emphasize proven
approaches for patients with specific characteristics.
Evidence 证据,迹象 guideline 指导方针 emphasize 强调
那些随机试验获得的临床
现和诊断思路是侧重于求证具有某些特征病人而来的
。
Substantial clinical judgment is required to determine whether the evidence
and guidelines apply to individual patients and to recognize the occasional
.
substantial clinical 真实的,实在的 individual 个体 occasional 偶尔
的,特殊的
实际的临床判断需要确定这些临床表现和诊断依据标准是否能应用于普通病人的
个体,并能找出例外。
Even more judgment is required in the many situations in which evidence
is absent or inconclusive.
inconclusive 不确定性,非决定性
在许多情况下,临床表现缺乏或不典型,甚至需要考虑得更多。
Evidence also must be tempered by patients’ preferences, although it is
a physician’s responsibility to emphasize when presenting alternative
options to the patient.
temper 脾气,调音 preference 偏爱 presenting 提出 alternative 可
选择的,二选一
虽然医生喜欢提出选择性问题让病人回答,但病人肯定会根据自己的倾向调节临
床症状。
The adherence of a patient to a specific regimen is likely to be enhanced
if the patient also understands the rationale and evidence behind the
recommended option.
adherence 坚持、固执 regimen 养生法、食物疗法
enhance 提高、加强 rationale 基本原理
假如还懂得所提供问题的基本原理和表现,有特殊生活方法病人的固执容易强化
这种倾向
To care for a patient as an individual, the physician must understand
the patient as a person.
care for 喜欢、照料
为了把病人作为一个个体进行治疗,医生必须理解病人是一个人(不是一群人)
。
This fundamental precept of doctoring includes an understanding of the
patient’s social situation, family issues, financial concerns, and preferences
for different types of care and outcomes, ranging from maximum prolongation
of life to the relief of pain and suffering.
precept 训戒 doctoring 行医 prolongation 延长
这个最基本的行医原则包括了解病人的社会地位,家庭问题,资金状况以及正确
理解病人对不同治疗方法、不同治疗结果的选择,从最大限度地延长生命到临时
缓解疼痛和症状。
Even as physicians become increasingly aware of new discoveries, patients
can obtain their own information from a variety of sources, some of which
are of questionable reliability.
questionable 可疑的、成问题的、不可靠的 reliability 可靠、可信赖的
甚至,当医生越来越容易知道新发现的同时,病人也能够通过各种途径得到他们
的信息,某些信息是不可靠的。
The increasing use of alternative and complementary therapies is an example
of patients’ frequent dissatisfaction with prescribed medical therapy
.
alternative 选择,替代 complementary 补充的、相配的 prescribe 规定、
指定、开处方
不断增加的替代疗法和辅助疗法的应用就是病人对常规疗法经常不满意的一个例
子。
Physicians should keep an open mind regarding unproven options but must
advise their patients carefully if such options may carry any degree
of potential risks, including the risk that they may relied on to substitute
for proven approaches
substitute 代替、代用 rely on 依赖、信任
医生对新疗法应该保持开放的思想,但是,如果这些疗法具有任何程度的潜在风
险,都必须细致地告知病人,包括可能需要用已证实的常规疗法去替代的风险。
It is crucial for the physician to have an open dialogue with the patient
and family regarding the full range of options that either may consider
crucial 严酷的、决定性的 either 两者任一
对医生来说,对病人及家属开诚布公地介绍所有可考虑的治疗选择,是非常重要
的。
The physician does not exist in a vacuum but rather as part of a complicated
and extensive system of medical care and pubic health.
vacuum 真空 extensive 广阔的、大量的
医生不是生存在真空中,而是作为一个复杂而庞大的医疗和公共健康体系中的一
部分。
In premodern times and even today in some developing countries, basic
hygiene, clean water, and adequate nutrition have been the most important
ways to promote health and reduce disease.
adequate 足够的、恰当的
在未发达时代,甚至当今在一些发展中国家,基本卫生条件、清洁饮用水和最低
营养保障是促进健康的最重要方法。
In developed countries, the adoption of healthy lifestyles, including
better diet and appropriate exercise, are cornorstones to reducing the
epidemics of obesity, coronary disease, and diabetes.
adoption 采纳、采用 epidemic 流行、传染
在发达国家中,健康的生活方式包括良好饮食和适当锻炼,是减少肥胖、冠心病
和糖尿病的基础。
Public health interventions to provide immunizations and to reduce injuries
and the use of tobacco, illicit drugs, and excess alcohol collectively
can produce more health benefit than nearly any other imaginable health
intervention.
illicit 非法的、违禁的 collectively 全体地、共同地 produce 生产、
创造
公共健康干预如进行疫苗接种、减少损伤、减少吸烟、减少吸毒、减少酗酒等措
施共同产生的健康效果比几乎可想象的任何其它健康干预措施都要好得多。
Chapter 6 Vital signs Page 15
第六章 生命体征 第15页
A nurse or assistant often obtains the vital signs.
护士或护士助手经常可得到生命体征
Traditionally the vital signs include pulse rate, blood pressure, respiratory
rate, and body temperature.
传统的生命体征包括脉搏(率)、血压、呼吸(频率)和体温。
More recently, advocates of various causes have advocated for a “fifth
vital sign”.
advocate 提倡、主张
最近,人们以多种理由提出 “第五生命体征”的建议。
The most cogent of these “new” vital signs is the patient’s quantitative
assessment of pain.
cogent 今人信服的,切实的,有力的
这些“新”的生命体征中,最今人信服的是病人疼痛的定量评判。
The pulse should be recorded as not just the rate but also the rhythm.
脉搏不仅要
频率,而且要记录节律。
Physicians may prefer to initiate the examination by holding the patient
’s hand while palpating the pulse.
initiate 开始,创始
医生喜欢握住病人的手,触摸脉搏,开始检查。
This nonthreatening initial contact with the patient allows the physician
to determine whether the patient has a regular or irregular rhythm.
这个对病人无威胁性的最初接触让医生确定了脉搏是否具有节律性。
When the blood pressure is abnormal, many physicians repeat the measurement
.
当测得的血压不正常,许多医生重复这个测量。
The instrument error that contributes to the greatest variability is the
cuff size of the sphygmomanometer.
variability 变化,易变性 sphygmomanometer 血压计
变异性中占比例最大的设备误差是血压计袖套的大小。
Many adults require a large-size adult cuff; using a narrow cuff can alter