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1临床医学英语Chapter1Patient-PhysicianInteractionPage1第一章医患沟通第1页Thepatient-physicianinteractionproceedsthroughmanyphasesofclinicalreasoninganddecisionmaking.proceed进行、开展reasoning推论、推理clinicalreasoning诊断clinicaldecision确定治疗方案makingdecision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。Theinteractionbeginswithanelucidationofcomplaintsorconcerns,followedbyinquiriesorevaluationtoaddresstheseconcernsinincreasinglypreciseways.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。Theprocesscommonlyrequiresacarefulhistoryorphysicalexamination,orderingofdiagnostictests,integrationofclinicalfindingswiththetestresults,understandingoftherisksandbenefitsofthepossiblecoursesofaction,andcarefulconsultationwiththepatientandfamilytodevelopfutureplans.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,理解分析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Physiciansincreasinglycancallonagrowingliteratureofevidence-basedmedicinetoguidetheprocesssothatbenefitismaximized,whilerespectingindividualvariationsamongdifferentpatientsrespecting注意到、关系、说到evidence-basedmedicine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。Theincreasingavailabilityofrandomizedtrialstoguidetheapproachtodiagnosisandtherapyshouldnotbeequatedwith“cookbook”medicineavailability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。Evidenceandtheguidelinesthatarederivedfromitemphasizeprovenapproachesforpatientswithspecificcharacteristics.Evidence证据,迹象guideline指导方针emphasize强调那些随机试验获得的临床表现和诊断思路是侧重于求证具有某些特征病人而来的。2Substantialclinicaljudgmentisrequiredtodeterminewhethertheevidenceandguidelinesapplytoindividualpatientsandtorecognizetheoccasional.substantialclinical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。Evenmorejudgmentisrequiredinthemanysituationsinwhichevidenceisabsentorinconclusive.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。Evidencealsomustbetemperedbypatients’preferences,althoughitisaphysician’sresponsibilitytoemphasizewhenpresentingalternativeoptionstothepatient.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。Theadherenceofapatienttoaspecificregimenislikelytobeenhancedifthepatientalsounderstandstherationaleandevidencebehindtherecommendedoption.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Tocareforapatientasanindividual,thephysicianmustunderstandthepatientasaperson.carefor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)。Thisfundamentalpreceptofdoctoringincludesanunderstandingofthepatient’ssocialsituation,familyissues,financialconcerns,andpreferencesfordifferenttypesofcareandoutcomes,rangingfrommaximumprolongationoflifetothereliefofpainandsuffering.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。Evenasphysiciansbecomeincreasinglyawareofnewdiscoveries,patientscanobtaintheirowninformationfromavarietyofsources,someofwhichareofquestionablereliability.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。Theincreasinguseofalternativeandcomplementarytherapiesisanexampleofpatients’frequentdissatisfactionwithprescribedmedicaltherapy.alternative选择,替代complementary补充的、相配的prescribe规定、指定、开处方3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。Physiciansshouldkeepanopenmindregardingunprovenoptionsbutmustadvisetheirpatientscarefullyifsuchoptionsmaycarryanydegreeofpotentialrisks,includingtheriskthattheymayreliedontosubstituteforprovenapproachessubstitute代替、代用relyon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。Itiscrucialforthephysiciantohaveanopendialoguewiththepatientandfamilyregardingthefullrangeofoptionsthateithermayconsidercrucial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。Thephysiciandoesnotexistinavacuumbutratheraspartofacomplicatedandextensivesystemofmedicalcareandpubichealth.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。Inpremoderntimesandeventodayinsomedevelopingcountries,basichygiene,cleanwater,andadequatenutritionhavebeenthemostimportantwaystopromotehealthandreducedisease.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。Indevelopedcountries,theadoptionofhealthylifestyles,includingbetterdietandappropriateexercise,arecornorstonestoreducingtheepidemicsofobesity,coronarydisease,anddiabetes.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。Publichealthinterventionstoprovideimmunizationsandtoreduceinjuriesandtheuseoftobacco,illicitdrugs,andexcessalcoholcollectivelycanproducemorehealthbenefitthannearlyanyotherimaginablehealthintervention.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。Chapter6VitalsignsPage15第六章生命体征第15页Anurseorassistantoftenobtainsthevitalsigns.护士或护士助手经常可得到生命体征4Traditionallythevitalsignsincludepulserate,bloodpressure,respiratoryrate,andbodytemperature.传统的生命体征包括脉搏(率)、血压、呼吸(频率)和体温。Morerecently,advocatesofvariouscauseshaveadvocatedfora“fifthvi
本文标题:临床医学英语重点句子翻译
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