Unit10-A+BGynecologicalDiseases妇科疾病翻译

•1•Unit10GynecologicalDiseases第10单元妇科疾病Pre-readingActivitiesang预习工作.Readthefollowingclinicalsituationanddecidewhatkindofinterventionyouwillsuggestandwhatdiseasethepatientmightbesufferingfrom.阅读下面的临床表现然后决定你将建议做那些干预，病人可能患了那种疾病。A55-year-oldwomancomestotheoutpatientofficecomplainingofpelvicpressureandab-dominalfullness.Herlastmenstrualperiod(LMP)was3yearsago.A、女性，55岁，门诊病人，住宿骨盆压迫感，腹部胀满。末次月经为3年前。在阅读这个文章前先理解一下术语。Trytounderstandthefollowingtermsbeforeyoureadthetext.gynecological[igainiks'bc^ikal]adj.oforrelatingtoorpracticinggynecology$3产科医学的ovarian[ou'vesrisn]adj.oforinvolvingtheovaries[解音I门卵巢的malignancy[ms'lignsnsi]n.(medicine)amalignantstate；progressiveandresistanttotreatmentandtendingtocausedeath恶性（肿瘤等）salpingectomy[iS2elpin'd3ekt3miJsurgicalremovalofoneorbothFallopiantubes[妇产]输卵管切除术hysterectomy[ihista'rektsmi]n.surgicalremovaloftheuterus子宫切除TextAOvarianGancortFocusAboutOvarianCanceriSignsandSymptomstCauses|DiagnosisClassificationStaging|Treatment+Prevention主题A卵巢癌重点：卵巢癌的相关体征和症状病因诊断分级分期|治疗预防AboutOvarianCancer关于卵巢癌Ovariancancerisacancerousgrowtharisingfromtheovary.OvarianCanceristhesecondmost•2•新编临床实用医学英语commonlydiagnosedgynecologicmalignancy，thedeadliestgynecologicmalignancy，andthefourthleadingcauseofcancer-relateddeathsinwomenintheUSA.About1in70womeneventuallydevelopovariancancer，and1in100womendiesofit.Ovariancanceraffectspre-dominantlyperimenopausalandpostmenopausalwomen.卵巢癌是一种子宫增生性癌。卵巢癌是妇产科疾病中的第二大疾病和最致命的疾病。是导致美国女性因肿瘤死亡的第四大疾病。大概70个女性中就有一个会发展成为卵巢癌，100中有1个因此而死。卵巢肿瘤主要发生在绝经前和绝经后的女性中。Etiologyandpathologyincidenceishigherinindustrializedcountriesinwhichdietaryfatintakeishigh.Ahistoryofinfertility，latechildbearinganddelayedmenopauseincreasesrisk.Useoforalcontraceptivessignificantlydecreasesrisk.病因学和病理学发病率在高脂饮食的工业化国家中高。有不孕史，晚育和更年期推迟都会增加发病风险。使用避孕药会显著增加发病风险。Apersonalorfamilyhistoryofendometrial,breast,orcoloncancerincreasesrisk.Probably5%ofovariancancercasesarerelatedtoaninheritedautosomaldominantgene,theBRCA1gene.FemaleswithXYgonadaldysgenesisarepredisposedtoovarianmalignantgermcelltumors.有子宫内膜、乳房或结肠癌个人或者家族史会增加发病风险。大约有5%的卵巢癌和染色体显性遗传有关,BRCA基因。女性XY性腺的发育不全有卵巢恶性生殖细胞肿瘤的发病倾向。Ovariantumorsarethemosthistologicallydiversegroupoftumors.Atleast80%ofmalignantovariantumorsarisefromthecoelomicepithelium.Germcelltumors,whicharisefromtheprimarygermcellsoftheovary,occurinyoungwomenandareuncommoninwomen30years.Malignantgermcelltumorsincludedysgerminomas,immatureteratomas,endodermalsinustumors，embryonalcarcinomas，choriocarcinoma，andpolyembryomas1•Stromalma-lignanciesincludegranulosathecacelltumorsandSertoli-Leydigcelltumors卵巢肿瘤在肿瘤中有丰富的组织多样性。至少有80%的恶性卵巢肿瘤是有宫腔上皮细胞发展来的。生殖细胞肿瘤是由卵巢的初级生殖细胞发展而来的，一般发生在年轻女性，极少发生在30岁的女性。恶性生殖细胞肿瘤包括恶性胚胎瘤，畸胎瘤，内胚层窦瘤，胚胎性绒毛膜癌，卵巢多胚瘤。基质见的恶性肿瘤包括卵泡膜细胞瘤和间质细胞瘤。Ovariancancerspreadsbydirectextension，byintraperinealimplantationviaexfoliationofcellsintotheperitonealcavity，bylymphaticdisseminationinthepelvisandpara-aorticre-gion,and,lesscommonly,hematogenouslytotheliverorlungs.SignsandSymptoms症状和体征Mostwomen(75%)presentwithadvanced-stagedisease，andmosthavevague，nonspecificsymptoms,suchasdyspepsia,bloating,early-satietyanorexia,gaspains,andback-ache.Themostcommonearlyfindingisanadnexalmass,whichisoftensolid,irregular,andfixed.Apatientmaybeasymptomaticuntilanabdominalmassisdiscoveredduringroutinepel-vicexaminationoruntilthediseaseisadvanced.Occasionally,apatientpresentswithsevereab-dominalpainsecondarytotorsionoftheovarianmass.Lateinthecourse,pelvicpain,anemia,cachexia,andabdominalswellingduetoovarianenlargementoraccumulationofasceticfluidusuallyoccur.Nodularimplantsnotedontherectovaginalexaminationsuggestextensivepelvicmalignantdisease.Ifthesesymptomsrecentlystartedandoccurmorethan12timespermonththediagnosisshouldbeconsidered.75%的女性会发展到疾病晚期，大部分人的症状都很模糊而且非特异，比如消化不良，腹胀，演示，腹胀，背疼。大部分女性发现疾病是因为子宫附件肿物，肿物呈质硬，不规则，固定。患者可能到体检发现腹部肿物或Unit10GynecologicalDiseases•3•者疾病晚期才发现。患者会在卵巢肿物蒂扭转是出现剧烈的腹痛。在病程晚期，会出现骨盆疼痛，贫血和恶病质，由于卵巢增大和积液引起的腹胀。在直肠阴道检查中会发现广泛的骨盆病变。如果症状早期和每个月12次复查可以预防。Functionaleffectsofgermcellorstromaltumorsincludehyperthyroidism，feminization，andvirilization11.However,benignfunctionalcystsarecommoninyoungwomen；vaginalsonographyorreexaminationafter6weekshelpsdifferentiatecystsfromtumors.Surgeryisin-dicatedwhenamassispersistentorsuspicious.生殖细胞肿瘤的功能影响包括甲亢，男性女性化和女性男性化。但是良性的功能囊肿也会发生在年轻女性身上；6周后的阴道超声或者复查有助于区别肿瘤和囊肿。肿瘤大量生长或者有恶变可能时进行手术。CausesOvariancancerisassociatedwithage,familyhistoryofovariancancer,anaemia,abdominalpain，abdominaldistension，rectalbleeding,postmenopausalbleeding,appetiteloss,andweight卵巢癌与年龄、卵巢癌家族史、贫血、腹痛、腹胀、直肠出血、绝经后出血、食欲减退、体重有关。Inmostcases,theexactcauseofovariancancerremainsunknown.Theriskofdevelopingovariancancerappearstobeaffectedbyseveralfactors：在大多数情况下，卵巢癌的确切原因尚不清楚。卵巢癌的发病因素可能有以下几个因素的影响：Olderwomenwhohavenevergivenbirth,andthosewhohaveafirstorseconddegreerelativewiththedisease,haveanincreasedrisk.从未生育过的女性，以及其一级亲属或二级亲属患有该病的女性，有增加的风险。Hereditaryformsofovariancancercanbecausedbymutationsinspecificgenes.特异性基因的突变也可导致卵巢癌遗传易感性。Infertilewomenandthosewithaconditioncalledendometriosis，andthosewhousepostmenopausalestrogenreplacementtherapyarea