General Anesthesia for Lumbar Puncture and Bone Marrow Aspiration Biopsy in Children with Cancer
常用医嘱术语(英文)
常用医嘱术语[Medical orders]（1）医嘱术语[medical orders]•Admit/transfer to[收入（转入）]•Resident/attending[住院（主诊）医师]•condition[病情]▲critical (Imminence)[病危]▲unstable[不稳定]▲stable[稳定]▲general (fair) [一般]•emergent[急诊]•Diagnosis[诊断]•Diet[饮食]▲full (home) diet[普食]▲l iquid (semi-liquid) diet[流汁（半流汁）饮食]▲soft diet[软食]▲low salt and low fat diet[低盐低脂饮食]▲salt-free diet[无盐饮食]▲low purine diet[低嘌呤饮食]▲low (non)-residue diet[少（无）渣饮食]▲light diet [清淡饮食]▲high caloric diet[高热量饮食]▲high protein (protein-rich) diet[高蛋白饮食]▲diab etic diet[糖尿病饮食]▲nephritic diet[肾炎饮食]▲nasal feeding[鼻饲]▲fasting (NPO, nothing by mouth)[禁食]▲NPO for 5 hours[禁食5小时]▲meal standard[伙食标准]•activity[活动]▲absolute rest[绝对卧床休息]▲stay on the bed (yest in bed)[卧床休息]▲Ad lib[随意活动]▲In the ward [病房内活动]•vital signs[生命体征]•Q shift (q.6h)[每班（每6小时）一次]•immoblization[制动]•pressed by sand bag [沙袋压迫]•I/O (intake and output)[记出入量]•N/A (non-apply)[不需要]•parameter: EKG(Bp,SaO2) monitor [其他：心电图（血压，氧饱和度）监护]•allergies[过敏]•NKA (non-known allergies)[无已知的过敏反应]•patient identification [病人身份]•4th floor,room 5 ,bed 2(405-2)[4楼5号房2床]•Med. Rec#[病历号]•medical orders[医嘱]•on general routine[护理常规]•on grade I (II, III) nuring care[I （I、III）级护理]•morning (evening) care[晨间（夜间）护理]•bedsore care[褥疮护理]•mouth (oral) care[口腔护理]•CP T( chest physical treatment) [胸部物理治疗]•O2 inhalation (2-4L/min)[吸氧（2-4升/分）]•alcohol sponge bath[酒精擦浴]•cold (hot) compress[冷（热）敷]•wet (hydropathic) compress by MgSO4[用硫酸镁湿敷]•change position × qh[每小时更换一次体位]•gastric lavage with water[用清水洗胃]•bladder irri gation [膀胱冲洗]•under water seal drainage of thorax[胸腔水封瓶引流]•GI decompression [胃肠减压]•keep warm[保温]医.学全在.线,提供ww w.m ed126.co m•lower temperature by ice-cap[冰帽降温]•keep bowels open[保持大便通畅]•keep the airway open[保持气道通畅]•retention catheterization[留置导尿]•prevent from bedsore[预防褥疮]•on bedside isolation[床边隔离]•P.P sitz bath[高锰酸钾液坐浴]•raising the head (foot) of the bed[抬高床头（尾）]•pencillin (procaine, iodine) skin test[青霉素（普鲁卡因，碘）皮试] •intubate and ventilator support[气管插管及呼吸机支持] •cleaning (retention) enama[清洁（保留）灌肠]•soapsuds (saline) enama[肥皂水（盐水）灌肠]•intradermal injection[皮内注射]•subcutaneous (hypodermic) injection [皮下注射] •intramuscular injection( i.m)[肌肉注射]•intravenous injection(i.v)[静脉注射]•intravenous drip(ivgtt)[静脉滴入]•intr aarterial injection[动脉注射]•intraarticular injection[关节内注射]•intrapleural injection[胸腔内注射]•intrathecal injection[鞘内注射]•intraspinal injection[椎管内注射]•per os(P.O,by mouth[口服]•inhalation[吸入]•inunction[涂擦]•scarification[划痕法]•by rectum[直肠灌注]•quaque die (q d)[一天1次]•bis in die(bid)[一天2次]•ter in die (tid)[一天3次]•quater in die (qid)[一天4次]•quaque hora (qh)[每小时1次]•quaque quarta hora(q4h)[每4小时1次]•quaque nocte (qn)[每晚1次]•quaque mane (qm)[每晨1次]•ante cibum(ac)[饭前（给药）]•post cibum (pc)[饭后（给药）]•hora somni (hs)[临睡时]•pro re nata (prn)[必要时]•si opus sit (sos)[必要时只用1次]•ante meridiem (am)[上午]•post meridiem (pm)[下午]•statim (st)[即刻](2)辅助检查术语[diagnostic examination]•CBC (complete blood count) [全血细胞计数]•WBC (white blood ount)[白细胞数]•RBC (red blood count) [红细胞数]•Ret (reticulocyte)[网织红细胞数]•HCT (hematocrit)[红细胞比积]•MCV (mean corpuscular volume) [红细胞平均体积] •MCH (mean corpuscular hemoglobin)[红细胞平均血红蛋白] •EC (eosinophic count)[嗜酸粒细胞计数]•Plt (platelet count)[血小板计数]•UA (urine analyse)[小便常规]•SRt (stool routine)[大便常规]•stool OB [大便隐血]•stool ova count[大便虫卵计数]•uric acid [尿酸]•uric (serum) amylase [尿（血）淀粉酶]•urine K+ (Na+)[尿钾（钠）测定]•pregnance test[妊娠试验]•urine Bence-Jone protein [尿本-周氏蛋白]•urinary protein electrophoresis[尿蛋白电冰]•bacterial count of urine [尿菌落数]•osmotic pressure assay[尿渗透压测定]•urine (blood, stool) culture [尿（血、大便）培养]•bone marrow puncture [骨穿]•iron staining of bone marrow smear [骨髓铁染色]•serum iron assay [血清铁测定]•Vit B12 and folic acid assay [维生素B12和叶酸测定]•BT (bleeding time) [出血时间]•CT (coagulation time) [凝血时间]•PT (prothrombin time)[凝血酶原时间]•ACT (activated coagulation time)[活化的凝血时间]•KPTT(kaolin partial thromboplastin time)[部分凝血活酶时间]•Fb (fibrinogen)[纤维蛋白原]•FDP (fibrinogen degradation product)[纤维蛋白原降解产物]•ABG (arterial blood gas)[血气分析]•renal function and liver function[肝肾功能]•D-dimer fragments assay[D-二聚体测定]•Hcy (homocysteine)[同型半胱氨酸]•Cr and BuN (creatinine and blood urea nitrogen)[肌酐和尿素氮]•blood lipid (TG, TC ,HDL, LDL)[血脂（甘油三酯，胆固醇，高密度脂蛋白，低密度脂蛋白）]•myocardial enzyme (CK, CK-MB, GOT, LDH)[心肌酶谱（肌酸磷酸激酶及同功酶，谷草转氨酶，乳酶脱氢酶）]•Mb (myoglobin)[肌红蛋白]•CTn-I [肌钙蛋白-I]•thyroid function (T3,T4,TSH,FT3 FT4,TG,TM)[甲状腺功能]•VMA (urine vanillylmandelic acid)[尿香草基杏仁酸]•LH, FSH, ACTH, GH[黄体生成素，卵泡刺激素，促肾上腺皮质激素，生长激素]•determination of calcitonin[降钙素测定]•17-KS and 17-OHCS[尿17-酮和17-羟测定]•plasma cortisol assay [皮质醇]•aldosterone assay[醛固酮]•testosterone and estradiol[睾酮和雌二醇]•FBS or blood glucose [空腹血糖或血糖]•SaO2 monitor [血氧饱和度监测]•CO2CP (carbon dioxide combining power)[二氧化碳结合力]•Uric ketobody[尿酮体]•serum electrolytes (K+,Na+,Ca2+,Cl-,Mg2+)[血电解质]•AFP(alpha-fetoprotein) [癌胚抗原]•β2-M(β2-microglobulin)[ β2微球蛋白]•Ccr (endogenous creatinine clearance)[内生肌酐清除率]•capillary resistance test [毛细血管脆性试验]•platelet adhesion and aggregation test[血小板粘附和凝集试验]•3P test (plasma protamine paracoagulation test)[血浆鱼精蛋白副凝试验] •plasma viscosity [血浆粘度]•whole-blood viscosity [全血粘度]•CSF (cerebrospinal fluid)[脑脊液]•semen (sputum, vaginal discharge) examination[精液（痰，阴道分泌物）检查]•total protein[总蛋白]•OGTT (oral glucose tolerance test)[口服糖耐量试验] •ASO (antistreptolysin O test)[抗“O”试验]•ANA (antinuclear antibody)[抗核抗体]•anti-ENA antibody [抗可提取性核蛋白（ENA）抗体] •anti-ds DNA[抗双链DNA抗体]•C3 (complement 3) [补体3]•CRP (C-reactive protein) [C-反应蛋白]•IC (immune complex)[免疫复合物]•RF (rheumatoid factor)[类风湿因子]•Widal`s reaction [肥达氏反应]•MIC (minimal inhibitory concentration)[最低抑菌浓度] •MBC (minimal bactericidal concentration)[最小杀菌浓度] •acid-fast stain[抗酸染色]•EKG [心电图]•bedside [床边]•chest (cervical) X-ray examination [胸部（颈部）X线检查] •P-A + lateral projection [正位+侧位]•echo (TTE, transthoracic echo)[经胸超声心动图]•echo (TEE, transesophageal echo)[经食道超声心动图] •Doppler echocardiography[多普勒超声心动图] •fluoroscopy [透视]医学全在线•CT (computerized-tomography)[计算机断层摄影]•MRI (magnetic resonance imaging)[核磁共振成像]•DSA (digital subtractive angiography)[数字减影血管造影术] •contrast enhancement[对比增强]•dacryocystography[泪囊造影]•Caldwell`s position [柯氏位]•Wayer`s position[瓦氏位]•Angiography [血管造影术]•coronary angiography [冠脉造影术]•right ventricul ography [右心造影术]•PTCA[经皮经腔冠脉成形术]•RFCA[经导管射频消融术]•stent[支架]•pacemaker implanted operation[起搏器植入术]•Holter (dynamic ECG)[24小时动态心电图]•ABPM[24小时动态血压监测]•treadmill test [平板运动试验]•bicycle ergometer[踏车试验]•tilt test[倾斜试验]•phonocardiog raphy[心音图]•atropine test[阿托品试验]•TEAP (transesophageal atrial pacing)[食道调搏]•EP study[电生理检查]•VCG (vectocardiogram)[心向量图]•EMG (electromyogram)[肌电图]•EEG (electroencephalogram)[脑电图]•barium enema[钡灌肠]•cholangiography[胆管造影术]•intravenous (oral) cholecystography[静脉（口服）胆囊造影] •pancratocholangiography[胰胆管造影]•selective heptatic arteriography[选择性肝动脉造影]•bronchography[支气管造影]•lung aspiration biopsy[肺针吸活检]•cystourethrography[膀胱尿道造影]•IVU (intravenous urography)[静脉尿道造影]•retrogradepyelography[逆行肾盂造影]•uterosalpingography[子宫输卵管造影]•CT-guided aspiration biopsy[CT 导向下穿刺活检]•cerebral angiography [脑血管造影]•vertebral angiography[椎动脉造影]•cisternography[脑室造影]•arterio (veno) graphy[动（静）脉造影]•lung functional examination[肺功能检查]•gastroscopy[胃镜检查]•endoscopy[內窥镜检查]•sigmoidoscopy[乙状结肠镜查]•colonoscopy[结肠镜检查]•colonofiberscopy[纤维结肠镜检查]•bronchoscopy[支气管镜检查]•ERCP (endoscopic retrograde cholangio-pancreatography)[经内镜逆行胰胆管造影] •catheterization[导尿术]医学全在线•thoracentesis[胸穿]•abdominocentesis（abdominal puncture）[腹穿]•pericardiocentesis[心包穿刺]•liver (renal) biopsy[肝（肾）活检]•bone marrow puncture[骨穿]•lumbar puncture[腰穿]•lymah node puncture [淋巴结穿刺]•joint cavity paracentesis [关节腔穿刺术]•examination of prostate[前列腺检查]•massage of prostate[前列腺按摩]•CVP measure [中心静脉压测定]•peripheral venous pressure measure [外周静脉压测定]•duodenal drainage[十二指肠引流]该文章转载自医学全在线：/yingyu/2008/20564_2.shtml。
Neuraxial Anesthesia — Spinal, Epidural, and Caudal …
Neuraxial Anesthesia — Spinal, Epidural, and Caudal Anesthesia Neuraxial anesthesia can be used alone, in combination with general anesthesia, or for post-op pain control. It is also useful in the management of chronic pain.•Advantages of these techniques — a potential reduction in post-operative morbidity, (and maybe mortality)o Decreased incidence of venous thrombosis or pulmonary embolismo Fewer cardiac complications in high risk patients by alleviating the stress responseo Less bleeding and fewer transfusion requirementso Decreased incidence of vascular graft occlusiono Decreased incidence of pneumonia and respiratory depression after upper abdominal and thoracic surgery in patients with COPDo Possibly earlier return of GI functiono In OB, neuraxial anesthesia allows the mother to stay awake for labor, vaginal delivery, or cesarean section, and is associated with lessmorbidity and mortality in cesarean sections than general anesthesia.•Proposed mechanisms to achieve these benefits:o Amelioration of the hyper-coagulable state associated with surgeryo Sympathectomy-induced increases in tissue blood flowo Improved oxygenation from decreased splintingo Enhanced peristalsiso Suppression of the neuro-endocrine stress response to surgery•Anatomyo Spinal canal contains the spinal cord enclosed in the dura mater and bathed in CSFo The epidural space:▪ Is bounded anteriorly by the posterior longitudinal ligament, laterally by the vertebral pedicles, and posteriorly by theligamentum flavum.▪Communicates with the paravertebral space by way of theintervertebral foramina.o The spinal cord extends from the foramen magnum to L1 in adults, L3 in children.o Anterior (motor) and posterior (sensory) nerve roots from the spinal cord join and exit the spinal canal through the intervertebralforamena to form spinal nerves. The lower nerve roots form the caudaequinao The dural sac extends to S1.o Blood supply to the spinal cord: anterior two-thirds by the unpaired anterior spinal artery from the vertebral artery. Posterior one third bypaired posterior spinal arteries from the inferior cerebellar arteries.Additional flow comes from the intercostals and lumbar arteries.•Mechanisms of action for neuraxial anesthesiao The principle site of action for neuraxial blockade is the nerve root.Local anesthetic is injected into the CSF (spinal anesthesia) or into theepidural space (epidural and caudal anesthesia), where it then bathesthe nerve root in the subarachnoid space or in the epidural space,respectively.o Direct injection of local anesthetic into the CSF for spinal anesthesia allows a relatively small dose and volume of local anesthetic toachieve a dense sensory and motor block. Achieving the same blockwith epidural or caudal administration of local anesthetic requiresmuch higher volumes and quantities of drug.o Other CNS effects: sedation, potentiation of sedative and hypnotic drugs, marked reduction of anesthetic requirements•Autonomic Blockadeo Sympathetic pre-ganglionic nerve fibers (small myelinated B fibers) exit the spinal cord with the spinal nerves from T1 to L2 and courseup or down the sympathetic chain before synapsing with a post-ganglionic cell in a sympathetic ganglia.o Parasympathetic pre-ganglionic fibers exit the brain and spinal cord with cranial and sacral nerves. Neuraxial anesthesia does not blockthe vagus or other cranial nerves. So the physiologic effects ofneuraxial blockade results from decreased sympathetic tone and/orunopposed parasympathetic tone.o Neuraxial blocks produce somatic blockade (interruption oftransmission of painful stimuli, and abolition of skeletal muscle tone),with decreased sympathetic tone and/or unopposed parasympathetictone.Systemic effects of neuraxial blocks•Cardiovascularo Cardiovascular effects, principally hypotension and bradycardia, are the most common and important physiologic changes associated withneuraxial anesthesia.o Blockade of sympathetic efferents is the mechanism by which these CV effects are produced.o The higher the block, the greater the sympathectomyo Sympathectomy produces▪Venous pooling in capacitance vessels →•Consequent decreased venous return to the heart →•Decreased cardiac output▪Arteriolar vasodilation →•Decreased peripheral vascular resistance →•Decreased blood pressure▪Decrease in heart rate may occur•Due to blockade of cardio-accelerator fibers at T1 –T4,leaving u nopposed vagal tone to the heart which,c ombined with profound hypotension, can progress tocardiac arrest.•Pre-existing heartblock may be a risk factor forprogression to higher grade block under neuraxialanesthesia.o The deleterious CV effects should be anticipated and preventative measures taken:▪ IV volume loading▪Left uterine displacement in advanced pregnancy▪Head-down positioning▪Atropine for bradycardia▪Vasopressors for hypotensiono Addition of epinephrine to epidural solutions will help counteract the cardiovascular effects of the anesthetic.•Pulmonaryo Pulmonary alterations with neuraxial anesthesia are usually minimal (unless the block is very high) because the diaphragm is innervated bythe phrenic nerve (C3-C5) with is rarely blocked.o Patients with severe chronic lung disease who rely on their accessory muscles of respiration may experience difficulty coughing andclearing secretions. Neuraxial anesthesia should be used with cautionin such patients.•Gastro-intestinalo Sympathetic blockade allows dominance of vagal tone and results in a small contracted gut with active peristalsis.•Endocrineo Blocks surgical stress responseo↓ Catecholamine releaseIndications for neuraxial anesthesiaIt can be utilized for any most any surgical procedure below the neck, but it is most useful for surgery below the umbilicus.Contraindications for neuraxial anesthesia•Patient refusal•Bleeding diathesis•Severe hypovolemia•Elevated ICP•Infection at the site of injection•Severe aortic stenosis or LV outflow tract obstructionNeuraxial blocks and concomitant anti-coagulants and anti-platelet drugs. The concern with these drugs is the risk of spinal hematoma when the block is performed or when an epidural catheter is manipulated or removed.•Oral anti-coagulants - Coumadino Coumadin must be stopped 5-7 days prior to surgery, and anormalized PT and INR (<1.2) must be documented before neuraxialanesthesia can be initiated.o If the patient received one dose of coumadin for DVT prophylaxis less than 24 hours prior to the block, it is probably safe to proceed. If thepatient received more than one dose, or if the dose was given morethan 24 hours prior to the block, a normalized PT and INR must bedocumented.o Besides stopping Coumadin, oral administration of Vitamin K over several days will help normalize the INR. If the surgery cannot bedelayed, IV administration of FFP should be used to providecoagulation factors.•Anti-platelet drugso Aspirin and NSAIDs do not appear to increase the risk of spinalhematoma.o Others platelet inhibitors must be stopped long enough for their effects to wear off:▪Ticlopidine (Ticlid) — 14 days▪Clopidogrel (Plavix) — 7 days▪Abciximab (Rheopro) — 48 hours▪Eptifibatide (Integrilin)— 8 hours•Unfractionated heparino Minidose subq heparin is not a contraindication to neuraxialanesthesia.o Blocks may be performed 1 hr or more before intraoperative heparino Epidural catheters should be removed 1 hr. prior to, or 4 hrs. after subsequent heparin doseso Avoid neuraxial anesthesia in patients on theraputic doses of heparin and patients with increased PTTo If epidural catheter is already in place when the patient is heparinized, wait to remove the catheter until heparin is stopped and coags arechecked.•Lovenoxo Avoid neuraxial anesthesia in patients already taking lovenoxo If bloody needle or catheter placement occurs, delay lovenox 24 hrso Remove epidural catheters 2 hrs. prior to initiation of lovenox. If already present, remove catheters 10 hrs after last dose of lovenox,and wait 2 hrs before any subsequent dosing.Complications of Neuraxial Anesthesia•High blocko Heralded by inability to talk, weak upper extremities▪Intubate to control ventilation and protect airway.▪Atropine for bradycardia▪Volume expansion and vasopressors for hypotension.•Cardiac arrest during spinal anesthesiao Many cases were preceded by bradycardia.o Often occurred in young, healthy patients, i.e. patients with high vagal tone.o Prophylactic volume expansion is recommended, along with aggressive treatment of bradycardia with atropine, and vasopressorsif necessary.•Urinary retentiono Blockade of S2-S4 foots decreases bladder tone and inhibits the voiding reflex.o Treatment: Foley catheterization until bladder function recovers.•Failed block – not high enough, not long enough•Intravascular injection during epidural or caudal blockso High serum concentrations of local anesthetics affect the CNS (seizures, unconsciousness) and the CV system (hypotension, rhythmand conduction abnormalities)o Minimize incidence by carefully aspirating before every injection, using a test dose, injecting local anesthetic in incremental doses, andobserving for signs of intravascular injection.•Subdural injection during epidural anesthesiao Produces a total spinal, except delayed 15-30 minuteso Requires intubation, mechanical ventilation, and CV support.•Backacheo Usually mild and self-limitingo Use Tylenol, Nsaids, and heating pado25-30% of patients receiving only general anesthesia have post-operative back ache. Many also have chronic back pain.•Post-Dural Puncture Headache. (PDPH)o Headache usually starts 12-72 hrs after needling of the subarachnoid space. Is bifrontal or retrobulbar and occipital extending into the neck.Associated with photophobia and nauseao Headache is positional — increases when standing or sitting up, gone when lying flato Cause is ongoing CSF losso Incidence higher in young patients, female patients, and pregnant patientso Conservative therapy: recumbent position, analgesics, hydration, and caffeine to stimulate CSF productiono If that fails, epidural blood patch to stop further CSF leakage. 90% effective. Carries same risks as epidural anesthesia, except higher riskof infection.•Neurologic injuryo Nerve roots or spinal cord may be injuredo Most resolve spontaneously within 6 months, some don’t•Spinal or epidural hematomao Usually in anti-coagulated patientso Symptoms are sharp back and leg pain, progressing to numbness, weakness, and loss of sphincter controlo If suspected, need immediate MRI and neurosurgical consultation.Best results if decompressed within 8-12 hrsSpinal AnesthesiaBlock height•The height of a spinal block is determined by cephalad spread of local anesthetic in the CSF.•Determining factors:o Baricity of the local anesthetic solution▪Hyperbaric solutions tend to drift downward due to gravity▪Hypobaric solutions tend to rise in CSF▪Isobaric solutions tend not to drift.o Patient position when the solution, whether hypobaric or hyperbaric, is injected or after it is injectedo Spinal level of injection siteo Lumbosacral CSF volume may play a part in determining block height, particularly in pregnant patientsDuration of block•Spinal blocks recede gradually from the most cephalad dermatome to the most caudad.•The principle determinant of block duration is the local anesthetic drug used: tetracaine > bupivacaine > lidocaine•Increasing the local anesthetic dose prolongs the duration of the block•Adding an adrenergic agonist (epinephrine or phenylepherine) to the local anesthetic solution may prolong the block. The mechanism is not clear –possibly by inducing local vasoconstriction, the rate of elimination of localanesthetic from the spinal cord and CSF is prolonged.Epidural AnesthesiaBlock Height•Injection site is the most important determinant of epidural block height.Unlike spinal anesthesia, epidural anesthesia produces a segmental blockthat spreads both caudally and cranially from the site of injection.•Local anesthetic dose•Local anesthetic drug volume•Effect of patient position during and after injection is controversial•Age of patient – greater spread in older patients. The epidural space is less compliant, and epidural solutions cannot leak out intervertebral foramina as easily in elderly patients.Duration of block•As with spinal aesthesia, he principle determinant of block duration is the local anesthetic drug used: bupivacaine and ropivacaine > lidocaine andmepivacaine > chloroprocaine•Dose of local anesthetic: increasing dose increases both duration and density of epidural block•Addition of epinephrine to local anesthetic solution will prolong the block。
关于“《护理学报》版面费、征订费、审稿费只接收银行汇款”的通知
第4期王晓艳等：神经｛科患者腰椎穿刺术后最佳卧床时间的循证实践35奠定了基础。
因此，基于证据的临床实践转化项目能够有效提高护士的执行力和管理能力的。
[参考文献][1]Engelborghs S,Niemantsverdriet E,Struyfs H,et al.Consensus Guidelines for Lumbar Puncture in Patients with Neurological Diseases!J].Alzheimers Dement(Amst),2017, 8(18):lll-126.DOI:10.1016/j.dadm.2017.04.007.[2]Headache Classification Subcommittee of the InternationalHeadache Society.The International Classification of Headache Disorders:2nd Edition[J].Cephalalgia,2004,24Suppl(1): 9-160.⑶尤黎明.内科护理学[M].北京：人民卫生出版社，2012.[4]Park S,Kim K,Park M,et al.Effect of24-Hour Bed Restversus Early Ambulation on Headache after Spinal Anesthesia:Systematic Review and Meta-analysis[J].Pain Manag Nurs,201&19(3)：267-276.D0I：10.1016/j.pmn.2017.10.012.[5]虎洁婷，李晓丽,章江琳，等.缩短腰椎穿刺术后绝对卧床时间对患者术后并发症影响的Meta分析[J].解放军护理杂志,201&35(4):9-15.D0I:10.3969/j.issn.1008-9993.2018.04.002.[6]Arevalo-Rodriguez I,Ciapponi A,Roque i Figuls M,et al.Posture and Fluids for Preventing Post-dural Puncture Headache[J].Cochrane Database Syst Rev,2016,3(3): CD009199.D0I:10.1002/14651858.CD009199.pub3.[7]兰大华，张曦，张诚，等.诊断性腰椎穿刺术后卧床30分钟效的Meta分析[J].杂志,2016,29(10): 1113-1115.DOI:10.13303/j.cjbt.issn.1004-549x.2016.10.009.[8]Choi JS,Chang SJ.A Comparison of the Incidence of Post-Dural Puncture Headache and Backache After Spinal Anesthesia:A Pragmatic Randomized Controlled Trial[J].Worldviews Evid Based Nurs,2018，15(1):45-53.D0I:10.1111/wvn.12236.[9]Tejavanija S,Sithinamsuwan P,Sithinamsuwan N,et al.Comparison of Prevalence of Post-dural Puncture Headache between Six Hour-supine Recumbence and Early Ambulation after Lumbar Puncture in Thai Patients:A Randomized Controlled Study[J].J Med Assoc Thai,2006,89(6):814-820.[10],.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志，2015,30(11):964-967.[11]朱丽，高凤,，等.的信效度测试[J].实护理杂志,2006(13):57-59.[12]Kolcaba KY.Holistic Comfort:Operationalizing the Construct as a Nurse-sensitive0utcome[J].ANS Adv Nurs Sci, 1992,15(1):1-10.[13]Bergstrom N,Braden BJ,Laguzza A,et al.The Braden Scalefor Predicting Pressure Sore Risk[J].Nurs Res,1987,36(4):205-210.[14],,兰,等.卧床患者发症护理[J].护理管理,2018,18(6):740-747.D0I:10.3969/j.issn.1672-1756.2018.06.006.[15]Kim SR,Chae HS,Yoon MJ,et al.No Effect of Recumbency Duration on the0ccurrence of Post-Lumbar Puncture Headache with A22G Cutting Needle[J].BMC Neurol,2012(12):1.D0I:10.1186/1471-2377-12-1. [16],,兰,等.患者术后护理证实践[J].护理学，2020,27(2):43-47.D0I:10.16460/j.issn1008-9969.2020.02.043.[本文编辑：吴艳妮]【信息】关于！《护理学&》版面费、征+费、审稿费只行汇4%的67《护理学报》版面费、征订费（编辑部订购）、审稿费只接收银行，，者、作者务行柜台或网上银行）1汇款银行信息：科大学：635357745047行：行和行$缴费注意事项2.1审稿费从银行柜台、网银或手机银行汇审稿费，30元/篇，请务必在备注注明“护理学报+稿件编号”！2.2版面费银行汇款付款人姓名务必为第一作者，否则编辑部无法核实;在附言内注明:“护理学报+稿号XXXXXXXX%,文章状态显示为待发表时，请务必在网站上点击“发票信息%-栏，填写需要开发票的单位抬头、单位税务登记号、详细的收件地址、收件电话号码、收件人等相关信息（2.3征订费在银行汇款单附言内注明收款单位、杂志邮寄地址、邮编、征订类别，如“附言：护理学报，xx市中医院护理部，528000,5人全年杂志”，并发送邮寄杂志的详细地址、邮、收件人姓名、件人联系电话等相关信息至本刊箱（**************）。
医学英文缩写一览表
医学英文缩写一览表 Revised as of 23 November 2020医院日常用品、设备英文单词Stethoscope[听诊器]Sphygmomanometer (Blood pressure gauge)[血压计]Thermometer[体温表]Tongue depressor (spatula)[压舌板]Needle[针头]Syringe[注射器]Cotton stick (ball)[棉签（球）]Bandage[绷带]Elastic bandage[弹力绷带]Esmarch`s bandage[橡皮绷带]Tourniquet[止血带]Gauze[纱布]Adhesive plaster[橡皮膏]Dressing[敷料] Splint[夹板]Rubber glove[橡皮手套]Sand bag[沙袋]Ice bag[冰袋]Hot water bottle[热水瓶]Bedpan[便盒]Urinal[尿壶]Catheter[导尿管]Rectal tube[肛管]Dilator[扩张器]Gastric tube[胃管]Lavage tube[洗胃管]Oxygen tube (cylinder)[吸氧管] Sengstaken-Blakemore tube[三腔二囊管] Visual testing chart[视力表]Incubator[保温箱] Plaster bed[石膏床] Sheet[被单]Bedding[被褥] Blanket[毛毯]Diaper[尿布]Pillow case[枕套] Bedside table[床头柜] Towel[毛巾]Basin[脸盒]Comb[梳子]Tooth-paste[牙膏] Tooth-brush[牙刷] Rubber cushion[橡皮圈] Air cushion bed[气垫床] Scale[台秤]Flashlight[电筒]Scissors[剪刀]Tray[托盘]Sputum cup[痰杯]Test tube[试管]Infusion support[输液架]Infusion drip monitor[输液滴速监护仪] Micropump[微泵]Operating table[手术台] Shadowless lamp[无影灯]Slit lamp[裂隙灯]Scalpel[手术刀]Silk sutures[丝线]Rubber drainage[引流管]Operating gown[手术衣]Overalls[工作服]Operating sheet[手术床单] Mask[口罩]Hemostatic forceps[止血钳] Needle forceps (holder)[持针钳] Dressing forceps[敷料钳] Smooth forceps[无齿镊] Tissue forceps[组织镊] Anesthesia machine[麻醉机] Electrocardiograph[心电图机] X-ray machine[X线机] Ventilator[呼吸机]Suction[吸引器]Tractor[牵引器]Rescue carrigae[抢救车] Stretcher[担架]Bedside monitor[床边监护仪] Defibrillator[除颤仪]Ambulance[救护车]Pacemaker[起搏器]Hyperbaric oxygen chamber[高压氧仓] Otoscope[耳镜]Rhinoscope[鼻镜] Ophthalmoscope[眼底镜] Esophagoscope[食道镜] Bronchofiberscope[纤支镜] Gastrofiberscope[纤维胃镜] Proctoscope[直肠镜] Peritoneoscope[腹腔镜] Sigmoidoscope[结肠镜]Cystoscope[膀胱镜]Microscope[显微镜]Thoracentesis set[胸穿包]Lumbar puncture set[腰穿包]Bone marrow puncture set[骨穿包]Abdominocentesis set[ [腹穿包] Venosection set[静切包]Transfusion set[输血包]Refrigerator[冰箱]Microwave oven[微波炉]Blood pressure monitor[血压监护仪] Automatic blood pressure meter( ABPM)[自动血压机]医学英文缩写一览表【单词缩写】each[各][抗体] [腹部]ABG-arterial blood gas[动脉血气] [异常]ABp-arterial blood pressure[动脉压] [无][摘要]meals[饭前][乙酰胆碱]cortical hormone[肾上腺皮质激素] coagulative time[活化凝血时间] [促肾上腺皮质激素]ad.(add.)-adde[加]ad effectum [直到有效]hormone[抗利尿激素]ad lib-at liesure[随意]adm.(admin)-adminstration[给药]ad us external use[外用]fibrillation[房颤]flutter[房扑]A/G ratio[白-球蛋白比]immune deficiency syndrome[爱滋病] ear[左耳][白蛋白]noon[上午][救护车]amp.(ampul)-ampoule[安瓿][麻醉][镇痛药]dinner[饭前]appr.(approx.)-approximately [大约] regurgitation[主闭]stenosis[主狭][阿斯匹林]septal defect[房缺]transaminase[谷草转氨酶]atm.(atmos.)-atomsphere[大气压] serum[抗破伤风血清][平均][钡]body temperature[基础体温]Calmette- Guerin[卡介苗][参考文献]a day[每日二次]metabolism[基础代谢] pressure[血压]bpm-baets per minute[次/分]sugar[血糖]weight[体重]centigrade[摄氏温度计][癌][癌]Cal. – calorie[卡]Cap. – capsule[囊]blood count[血常规]complaint[主诉]CC. condition list[病危通知单]Coronary care unit[冠心病监护室] delivered[剖腹产]date of confinement[预产期]antigen[癌胚抗原]group[对照组]kinase[肌酸激酶][毫开][毫米]nervous system[中枢神经系统] [复方][禁忌]computerized tomography[计算机断层扫描]vitae[简历]DBp-diastolic blood pressure[舒张压]differential diagnosis[鉴别诊断][科][诊断]DIC-disseminate intravascular coagulation[弥漫性血管内凝血][分升]mellitus[糖尿病]murmur[舒张期杂音]on arrival[到达时已死亡]of birth[出生日期][医生]in water[葡萄糖液]D-5-W,-5% dextrose in water[5%葡萄糖液]DU-duodenal ulcer[十二指肠溃疡]ECG.(EKG.)- electrocardiograph[心电图] ECHO .-echogram[超声]EDD.(EDC)-expected date of delivery (confinement)[预产期]ENT. – ears, nose and throat[五官科]EMG. – electromyogram[肌电图]ER. – emergency room[急诊室]et elsewhere[等等]etc. – and so forth[等等]F.(Fahr.)-Fahrenheit [华氏]F- Female[女性]fasting blood sugar[空腹血糖]degradation products[纤维蛋白原降解产物] FFA. – free fatty acid[游离脂肪酸]FUO. – fever of unknown origin[不明原因发热] FX. – fracture [骨折]GH. – growth hormone[生长素]gastrointestinal[消化]GITS. – gastrointestinal therapy system[胃肠治疗系统]gtt. – drops[滴]gastric ulcer[胃溃疡]Hb. – hemoglobin[血红蛋白]blood pressure[高血压]HCG. – human choroionic gonadotropic hormone[人绒毛膜促性腺激素]high density lipoprotein[高密度脂蛋白] rate[心率][身高][高血压][病历]injection[皮下注射]– aortic balloon pacing[主动脉内囊反搏] I/ and output [进出量]ICU. – intensive care unit[重症监护病房] ie. – that is [即]Ig. – immunoglobulin[免疫球蛋白]Im. – iutramuscular[肌内的]inhalation[吸入]isoniazid[异烟肼]injection[注射]intern[实习生]in-patient[住院病入]international unit[国防单位][静脉内]joule[焦耳][肾、输尿管和膀胱]blood pressure [低血压]LC. – laparoscopic cholecystectomy[腹腔镜胆囊切除术]density lipoprotein[低密度脂蛋白]Liq. – liquid[液体]last menstrual period[未次月经]LP. –lumbar puncture[腰穿]M. –male[男性]corpuscular diameter[平均红细胞直径]corpuscular hemoglobin[平均红细胞血红蛋白量] corpuscular hemoglobin concentration[平均红细胞血红蛋白浓度]corpuscular volume[平均红细胞体积]infarction[心梗][分]mixt。
神经外科常用英文词汇
神经系统（nervous system）是机体内对生理功能活动的调节起主导作用的系统，主要由神经组织组成，分为中枢神经系统（central nervous system）和周围神经系统（peripheral nervous system）两大部分。
中枢神经系统又包括脑（brain）和脊髓（spinal cord），周围神经系统包括颅神经（cranial nerves，也称“脑神经”）和脊神经（spinal nerves）。
神经组织是由神经细胞和神经胶质细胞（glial cell）组成的，它们都是有突起的细胞。
神经细胞是神经系统的结构和功能单位，亦称神经元（neuron）。
神经元数量庞大，它们具有接受刺激、传导冲动和整合信息的能力。
有些神经元还有内分泌功能。
01 常见词根词缀合集neur神经，神经系统（neurotoxic神经毒性的）encephal脑（encephaledema脑水肿）cerebr大脑（decerebrate切除大脑，消除大脑功能）cerebell小脑（cerebellospinal小脑脊髓的）mening脑膜（meningorrhagia脑膜出血）ventricul脑室thalam丘脑ax轴突（axonal轴突的）dendr树突（dendriceptor树突受体的；dendriform树状的）gangli/gonglion神经节neuron神经元gli神经胶质（gliophagia神经胶质细胞吞噬作用）cortic皮质medull髓（medullary髓质的，延髓的；medulloculture骨髓培养）myel脊髓（poliomyelosis脊髓灰质炎；myelosis骨髓瘤形成; 骨髓组织增生）psych精神的（psychosomatic身心的，心身失调的；psychotropic作用于精神的）somn睡眠（somnolence嗜睡）-algia痛（arthralgia关节痛）-esthesia感觉，知觉（anesthesia麻醉，麻木）-lepsy突然发作（epilepsy癫痫）-lexia阅读-paresis偏瘫（左/右边的一半）（hemiparesis轻偏瘫）-phasia言语-plegia瘫痪（quadriplegia四肢麻痹，四肢瘫痪；facioplegia面瘫；paraplgia截瘫，半身不遂）-phobia恐惧hemi-一半（hemianesthesia偏侧感觉缺失）intra-内02 单词词组学习*神经系统&大脑neuron神经元ganglion神经节glial神经胶质的axon轴突dendrite树突sympathetic交感神经parasympathetic副交感神经innervate 使受神经支配的medulla oblongata延髓cerebrum大脑hemisphere大脑半球cerebellum小脑thalamus丘脑hypothalamus 下丘脑；丘脑下部pons脑桥meninges脑膜cavity/ventricle脑室词根cerebell/o: cerebellum 小脑cerebellar 小脑的cerebellitis 小脑炎cerebellopontine 小脑脑桥cerebr/o: cerebrum 大脑cerebral 大脑的cerebrospinal fluid 脑脊液cerebral artery 大脑动脉cerebral cortex 大脑皮层encephala/: brain 脑encephalitis 脑炎encephalopathy 脑病（hepatic encephalopathy肝性脑病）electroencephalogram 脑电图Mening/o：脑膜Meningitis 脑膜炎Meningeal 脑膜的Meningioma 脑膜瘤Kinesia: movement 运动Bradykinesia 运动徐缓（见于Parkison disease）Dyskinesia 运动障碍Esthesia: 感觉Hyperesthesia 感觉过敏Anaesthesia 麻醉（没有感觉）Paresis: 无力Hemiparesis 轻偏瘫Plegia: 瘫痪Hemiplegia 偏瘫Paraplegia 截瘫Quadriplegia 四肢瘫这几个看下图就明白了（但要学会掌握这些词根：hemi -, para -, quadra-）神经系统有个很有意思的词是arachoid，有个经典的疾病是subarachoid hemorrhage(蛛网膜下腔出血).Arachoid 这个词来源于希腊神话。
阿尔茨海默病诊断标记物1
470 Current Alzheimer Research, 2010, 7, 470-4761567-2050/10 $55.00+.00©2010 Bentham Science Publishers Ltd.The Cerebrospinal Fluid Amyloid 42/40 Ratio in the Differentiation of Alzheimer’s Disease from Non-Alzheimer’s DementiaP.E. Spies 1,4,*, D. Slats 1,4, J.M.C. Sjögren 1,4,5, B.P.H. Kremer 3, F.R.J. Verhey 6, M.G.M. Olde Rikkert 1,4 and M.M. Verbeek 2,3,4Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands, 1Department of Geriatric Medicine, 2Department of Laboratory Medicine, 3Department of Neurology, 4Alzheimer Centre, Nijmegen, 5Schering-Plough Research Institute, 6Alzheimer Centre, Maastricht, Oss, The Nether-landsAbstract: Background: Amyloid 40 (A 40) is the most abundant A peptide in the brain. The cerebrospinal fluid (CSF) level of A 40 might therefore be considered to most closely reflect the total A load in the brain. Both in Alzheimer’s dis-ease (AD) and in normal aging the A load in the brain has a large inter-individual variability. Relating A 42 to A 40 lev-els might consequently provide a more valid measure for reflecting the change in A metabolism in dementia patients than the CSF A 42 concentrations alone. This measure may also improve differential diagnosis between AD and other dementia syndromes, such as vascular dementia (VaD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD).Objective: To investigate the diagnostic value of the CSF A 42/A 40 ratio in differentiating AD from controls, VaD, DLB and FTD.Methods: We analysed the CSF A 42/A 40 ratio, phosphorylated tau 181 and total tau in 69 patients with AD, 26 patients with VaD, 16 patients with DLB, 27 patients with FTD, and 47 controls.Results: Mean A 40 levels were 2850 pg/ml in VaD and 2830 pg/ml in DLB patients, both significantly lower than in AD patients (3698 pg/ml; p<0.01). A 40 levels in AD patients were not significantly different from those in controls (4035 pg/ml; p=0.384). The A 42/A 40 ratio was significantly lower in AD patients than in all other groups (p <0.001, ANCOVA). Differentiating AD from VaD, DLB and non-AD dementia improved when the A 42/A 40 ratio was used in-stead of A 42 concentrations alone (p<0.01) The A 42/A 40 ratio performed equally well as the combination of A 42, phosphorylated tau 181 and total tau in differentiating AD from FTD and non-AD dementia. The diagnostic performance of the latter combination was not improved when the A 42/A 40 ratio was used instead of A 42 alone.Conclusion: The CSF A 42/A 40 ratio improves differentiation of AD patients from VaD, DLB and non-AD dementia pa-tients, when compared to A 42 alone, and is a more easily interpretable alternative to the combination of A 42, p-tau and t-tau when differentiating AD from either FTD or non-AD dementia.Keywords : Abeta40 protein, A 42/A 40 ratio, Alzheimer’s disease, vascular dementia, dementia with Lewy bodies. INTRODUCTIONWhile making an accurate diagnosis is important for management of dementia, differentiating between Alz-heimer’s disease (AD) and other types of dementia using clinical criteria is the true clinical challenge: difficult and prone to inaccuracy. The NINCDS-ADRDA criteria for AD [1] have been validated against neuropathological standards and turned out to have a specificity of 23-69% for differenti-ating AD from other dementias [2, 3].Analysis of cerebrospinal fluid (CSF) has been used in-creasingly to differentiate the various dementia disorders [4]. Although CSF analysis of amyloid 42 (A 42), phosphory-lated tau 181 (p-tau 181) and total tau (t-tau) is efficacious in*Address correspondence to this author at the Department of Geriatric Medicine, 925, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Tel: +31 24 361 6772; Fax: +31 24 361 7408; E-mail: p.spies@ger.umcn.nldistinguishing between AD dementia and non-demented con-trols, it is inaccurate in separating AD from other types of dementia [5-7]. CSF biomarker profiles of AD, vascular de-mentia (VaD), frontotemporal dementia (FTD), and demen-tia with Lewy bodies (DLB) overlap, which makes discrimi-nation between these various dementias based on CSF analy-sis alone difficult.It has been suggested that relating A 42 to the concentra-tion of A 40 may improve diagnostic accuracy of CSF analy-sis [8]. A 40 is the most abundant A peptide in human CSF, whereas A 42 accounts for only 10% of the total A popula-tion [6, 9-11]. As such, CSF A 40 concentrations could be considered as the closest possible reflection of the total A load in the brain. This total CSF A load shows a large inter-individual variability [12]. Patients with a low total A load and therefore a low CSF A 42 concentration [11], might re-ceive an inappropriate diagnosis of AD if only CSF A 42 is considered and an absolute cut-off value is used. Similarly, in patients with AD but with a high total A load, CSF A 42The Cerebrospinal Fluid Amyloid 42/40 Ratio in the Differentiation Current Alzheimer Research, 2010, Vol. 7, No. 5 471concentrations may not decrease below the cut-off value and in those cases rejection of the diagnosis AD might be incor-rect. Since the total A concentration was found not to change in various dementia disorders [8, 10, 13], and A 40 concentrations were shown to be similar in groups of AD patients, controls and non-AD dementia patients [13-17], hypothetically the ratio of A 42 to A 40 reflects the A changes in the brain more accurately than A 42 alone.It was found in several studies that differentiation be-tween AD and healthy controls, subjects with non-AD de-mentia, or subjects with other neurological disorders, im-proved when using the CSF A 42/A 40 ratio compared to A 42 alone [15, 17, 18], although these results were not con-firmed in other studies [19, 20]. The A 42/A 40 ratio has pre-viously been studied in patients with FTD and AD, and a significantly decreased A 40 was found in FTD patients, re-sulting in an increased A 42/A 40 ratio compared to AD pa-tients [21]. In a recent review it was concluded that levels of CSF A 40 or A 42 cannot usefully discriminate between AD and DLB [22], although one study found that the A 42/A 40 ratio improved diagnostic accuracy of AD versus DLB rela-tive to A 42 alone [23]. To our knowledge, the A 42/A 40 ratio has not been investigated in relation to VaD.We hypothesized that differentiation between dementia syndromes would improve by using the CSF A 42/A 40 ratio since it may eliminate inter-individual differences in total A load. Therefore, we explored the CSF A 40 concentration and A 42/A 40 ratio in patients with AD, VaD, DLB, FTD and in controls, and we investigated the diagnostic value of the A 42/A 40 ratio in differentiating AD from each of these groups individually as well as from the total group of non-AD dementia patients.MATERIALS AND METHODSPatientsSixty-nine AD, 26 VaD, 27 FTD, and 16 DLB patients were included in this study that was based on the CSF data-base of the Alzheimer Centre of the Radboud University Nijmegen Medical Centre. This database contains clinical data as well as biobanked CSF and serum of consecutive patients. All patients or their legal representative had given informed consent for lumbar puncture. We included all pa-tients with a clinically clear-cut dementia diagnosis, whose CSF was available for A 40 and A 42 analysis. Data on t-tau and p-tau181 were also obtained. A diagnosis was made by a multidisciplinary team, which consisted of a geriatrician, neurologist, neuropsychologist, and – if needed – an old-age psychiatrist. The panel used the accepted clinical diagnostic criteria, i.e. the NINCDS-ADRDA criteria for probable AD, the NINDS-AIREN criteria for probable VaD, the 1998 con-sensus on clinical diagnostic criteria for FTD and the 1996 consensus guidelines for the clinical and pathologic diagno-sis of DLB [1, 24-26]. In less than 10% of the cases, the cli-nicians were aware of the CSF results for A 42, p-tau181 and t-tau when establishing the clinical diagnosis, but they were never aware of A 40 levels.The control group consisted of 47 non-demented patients who underwent lumbar puncture for various complaints. Most frequently diagnosed were headache (n=10), polyneu-ropathy (n=5), radiculopathy (n=4), vertigo (n=3), and delir-ium (n=2). The remaining controls had a variety of com-plaints but turned out not to have central neurological prob-lems. CSF cell count, glucose, lactate, haemoglobin, biliru-bin, total protein and oligoclonal IgG bands were normal in all controls. Patient characteristics are listed in Table 1.CSFCSF was collected by lumbar puncture in polypropylene tubes, transported within 30 minutes to the adjacent labora-tory at room temperature, centrifuged after routine investiga-tions, and immediately aliquoted and stored at –80 °C until analysis. Levels of A 42,t-tau, and p-tau181 in CSF were measured using enzyme linked immunosorbent assays (In-nogenetics NV, Gent, Belgium). Inter-assay coefficients of variation for these assays were 3.8 – 8.4% [27]. CSF A 40 was analysed by using a commercial assay based on the Lu-minex technology (BioSource, Invitrogen Ltd, Paisley, UK). Inter-assay coefficient of variation for A 40 was 5.4% (at 2875 pg/ml; n=32). The lower limit of detection was for A 42 50 pg/ml and for A 40 22 pg/ml.Statistical AnalysisSincep-tau181, t-tau, A 42, A 40, and the A 42/A 40 ratio were not all normally distributed, they were log-transformed. Differences in p-tau181, t-tau, A 42, A 40 and the A 42/A 40 ratio were analysed using 2-way ANCOVA. Since sex and age did not contribute to the differences in A 42, A 40 and the A 42/A 40 ratio between dementia groups and controls, both (sex and age) were removed from the model and the ANCOVA was thereafter rerun. Differences between AD and the other groups were further explored using Dunnett’s post-hoc test.We used logistic regression analysis to assess the value of the A 42/A 40 ratio compared to other combinations of CSF biomarkers in differentiating AD from controls, from VaD, FTD, DLB, respectively, and from these three groups combined (‘non-AD dementia’). Sex and age contributed significantly to the logistic regression models and therefore the models were corrected for these factors. Receiver operat-ing characteristic (ROC) curves were calculated and the ar-eas under the ROC curves were compared using MedCalc (Mariakerke, Belgium). Sensitivity and specificity were de-termined based on the highest Youden index, i.e. the point on the ROC curve at which sensitivity + specificity – 1 is maximized. All other statistical analyses were carried out using SPSS, version 16.0.ResultsThe mean level of CSF A 40 was significantly lower in VaD patients than in AD patients (p<0.001), as well as in DLB patients compared to AD patients (p=0.008) (see Table 1 and Fig. (1)). There was no significant difference in A 40 levels between AD patients and FTD patients (p=0.981) or controls (p=0.384). In AD patients, the concentration of CSF A 42 was significantly lower than in VaD and FTD patients and controls (p<0.001), whereas the concentration of p-tau181 and t-tau was significantly higher than in all other groups (p<0.001).The A 42/A 40 ratio was significantly lower in AD patients than in all other groups (p <0.001) (see Table 1 and Fig. (1)).472 Current Alzheimer Research, 2010, Vol. 7, No. 5 Spies et al.We investigated the diagnostic value of the A 42/A 40 ratio in several comparisons. First, we investigated if the use of the A 42/A 40 ratio would be superior to the use of A 42 alone. Differentiation of AD from either VaD, DLB or non-AD dementia significantly improved when using the A 42/A 40 ratio (p<0.01). In contrast, differentiation of AD from either FTD or controls did not improve (p> 0.05). Sec-ond, we analysed the diagnostic value of the A 42/A 40 ratio compared to the combination of A 42, p-tau181 and t-tau, which is a frequently used combination of CSF biomarkers in AD research. Differentiation of AD from either FTD or non-AD dementia was equally good for the A 42/A 40 ratio or the combination of A 42, p-tau181 and t-tau (p >0.05). Dif-ferentiation of AD from either controls, VaD or DLB was better using the combination of A 42, p-tau181 and t-tau than using the A 42/A 40 ratio (p<0.05). Third, we analysed if replacement of A 42 by the A 42/A 40 ratio in the combina-tion with p-tau181 and t-tau would improve results. Differen-tiation of AD from both controls and from all dementia groups was equally good for both combinations (p >0.05). ROC curves are shown in Fig. (2) and Fig. (3). Sensitivity and specificity, AUC and likelihood ratios of each parameter are shown in Table 2.DISCUSSIONWe explored the CSF A 40 concentrations in patients with different types of dementia and in controls, and exam-ined the value the A 42/A 40 ratio in differentiating AD from controls, from FTD, DLB, VaD, and from these latter three groups combined. The observed patterns of A 40 and A 42 in the various dementia groups are remarkable. As expected, the AD group was characterized by normal A 40 and low A 42 levels, but contrary to our expectations, the VaD group had low A 40 and intermediate A 42 levels, whereas the DLB group was characterized by low concentrations of both A 40 and A 42 levels. The FTD group had normal A 40 and A 42 levels.Only one study has reported the CSF A 40 concentration in patients with VaD. In accordance with our results, a lower A 40 concentration in VaD patients compared to AD patients was found [28]. Multiple explanations for this low A 40 con-centration are possible. For example, it may be caused by the ischemic damage that has occurred in VaD patients, since cerebral ischemia has been shown to result in plaque forma-tion and accumulation of A 40 and A 42 [29-31] and, conse-quently, leads to a reduced CSF concentration. In addition, atherosclerosis, one of the risk factors for VaD, may inhibit the clearance of A 40 across the blood-brain barrier, leading to vascular deposits of A 40 [32].Our finding of a lower A 40 concentration in DLB pa-tients compared to AD is in accordance with the literature [12]. Possibly, the intraneuronal -synuclein aggregates that are found in DLB affect A metabolism, leading to an over-all decrease in A synthesis. Results from in vitro research indicate an interaction between -synuclein and A [33, 34]. Neuropathological studies found a positive correlation be-tween A plaque burden and -synuclein load [35, 36]. A 40 plaque level was greater in cases with -synuclein aggregates compared to cases lacking -synuclein aggregates, while no difference was found in A 42 plaque burden [35]. A greater A 40 plaque burden in DLB might explain the decreased A 40 concentration in CSF that we found.The few studies that measured A 40 concentration in FTD patients report varying results. Our results are supported by previous findings of similar concentrations of A 40 in FTD patients and AD patients [37]. In contrast with this, another group reported lower A 40 concentrations in FTD patients compared to AD patients [21]. The varying results might be explained by the inclusion of heterogeneous FTD patient groups in research, comprising patients with clinically diag-nosed FTD, semantic dementia and primary progressive aphasia, presumably with different neuropathological sub-strates.Table 1. Clinical Characteristics and Results of CSF AnalysisControls AD VaD FTD DLB males/females (n) 23/24 34/35 17/9 19/8 12/4 age (y) 61 ± 8 69 ± 8 72 ± 9 65 ± 7 76 ± 8disease duration (mo) n.a. 29 ± 23n=60 35 ± 29n=2034 ± 21n=2634 ± 27n=8t-tau (pg/ml)* 221 ± 80 710 ± 390 391 ± 526 448 ± 315 257 ± 98p-tau181 (pg/ml)* 49 ± 16 111 ± 52 46 ± 16 70 ± 36 53 ± 17A 42 (pg/ml)* 840 ± 260 428 ± 127 631 ± 270 786 ± 229 499 ± 179A 40 (pg/ml)* 4035 ± 1177 3698 ± 1096 2850 ± 1031 3590 ± 1038 2830 ± 697A 42/A 40 ratio* 0.21 ± 0.04 0.12 ± 0.04 0.23 ± 0.08 0.23 ± 0.06 0.18 ± 0.06 Values are expressed as means ± SD.*, p-value <0.001 by ANOVA.AD, Alzheimer disease; VaD, vascular dementia; FTD, frontotemporal dementia; DLB, dementia with Lewy bodies; t-tau, total tau; p-tau181, phosphorylated tau181; n.a., not applica-ble.The Cerebrospinal Fluid Amyloid 42/40 Ratio in the Differentiation Current Alzheimer Research, 2010, Vol. 7, No. 5 473Fig. (1). Cerebrospinal fluid A 42 and A 40 concentrations and A 42/A 40 ratio in controls and patients with various types of de-mentia.See text for statistical analyses.Bold horizontal bar represents the median. Central box: 25th to 75th percentile (interquartile range). Vertical bar bordered by highest and lowest value within 1.5 * interquartile range.AD, Alzheimer disease; VaD, vascular dementia; FTD, frontotem-poral dementia; DLB, dementia with Lewy bodies.We investigated the A 42/A 40 ratio under the assumption that A 40 closely represents the total cerebral A load. Since we found different A 40 concentrations in the various de-mentia groups, it can be debated if the A 42/A 40 ratio is a good representation of the A 42 fraction of the total A load and thus eliminates inter-individual differences in total A concentrations. Nevertheless, differentiating AD from VaD, DLB and non-AD dementia improved when we used this ratio compared to A 42 alone, probably due to the differences in A 40 concentrations. Results obtained by applying the A 42/A 40 ratio fulfilled the criteria for biomarkers as estab-lished by the Working Group on molecular and biochemical markers of Alzheimer’s disease [38] in differentiating AD from VaD, FTD, DLB, and non-AD, since both sensitivity and specificity were >80%.TheA 42/A 40 ratio seems to be a good alternative for the combination of A 42, p-tau181 and t-tau, to distinguish AD from either FTD or non-AD dementia. The A 42/A 40 ratio has the advantage that only two analyses are needed instead of three, and, consequently, the results are easier to interpret. The differentiation of AD from non-AD dementia is a fre-quently encountered problem in clinical practice, when de-mentia can be established, but the differential diagnosis en-compasses AD and another type of dementia. Thus, the use of the CSF A 42/A 40 ratio may help in this clinical decision making. However, the use of four biomarkers, i.e. the A 42/A 40 ratio combined with p-tau181 and t-tau, did not improve differentiation when compared to the combination of the three currently used biomarkers A 42, p-tau181 and t-tau.Some bias may have occurred in our analysis since in less than 10% of the patients the results of the CSF analysis for A 42, t-tau and p-tau181 were known to the clinicians. However, given the small fraction of patients this applies to, we believe that this did not affect our results, also since our sensitivity and specificity results for discriminating AD from other dementias using A 42 are comparable with the litera-ture [18, 39, 40]. The number of patients in our non-AD groups were moderate, yet not very different from the num-bers mentioned in other studies [12, 21, 28, 37]. Besides,the significant results that we found had a p-value <0.01, sug-gesting that these results are not expected to change with an increasing number of patients.In summary, the A 42/A 40 ratio is more accurate for dif-ferentiating AD from other types of dementia than A 42 alone, and can be a good and easier interpretable alternative for the combination of the established biomarkers A 42, p-tau181 and t-tau for the differentiation of AD from non-AD dementia, which may help to accept or refute the clinical diagnosis of AD.ACKNOWLEDGEMENTSThe authors wish to thank the technicians of the Depart-ment of Laboratory Medicine for CSF analysis. The authors have all contributed to the work and agree with the presented findings.This work was supported by a grant from the Centre for Translational Molecular Medicine, LeARN project - a Dutch public-private partnership on the development and valorization of innovative diagnostic techniques for early detection of Alzheimer Disease; MV is supported by a Zon-MW Innovational Research grant (Vidi program no. 917.46.331). MSj is employed by Schering-Plough and has an affiliation to the Radboud University Nijmegen Medical Centre. There are no conflicts or interests with regard to theresearch performed in this study.474 Current Alzheimer Research, 2010, Vol. 7, No. 5 Spies et al.Fig. (2). Receiver Operating Characteristic curves comparing A 42, and the A 42/A 40 ratio in AD versus controls and versus various types of dementia. AD, Alzheimer disease; VaD, vascular dementia; FTD, frontotemporal dementia; DLB, dementia with Lewy bodies.Fig. (3). Receiver Operating Characteristic curves comparing the A 42/A 40 ratio, the A 42/A 40 ratio combined with p-tau181 and t-tau, and the combination of A 42, p-tau181 and t-tau in AD versus controls and versus various types of dementia. AD, Alzheimer disease; VaD, vascu-lar dementia; FTD, frontotemporal dementia; DLB, dementia with Lewy bodies.The Cerebrospinal Fluid Amyloid 42/40 Ratio in the Differentiation Current Alzheimer Research, 2010, Vol. 7, No. 5 475 Table 2. Sensitivities and Specificities, AUC and Likelihood Ratios for Discriminating Alzheimer’s Disease from Controls and from Other Types of Dementia, Using Different Combinations of CSF BiomarkersADvs. controls AD vs. VaD AD vs. FTD AD vs. DLB AD vs. non-ADsens. spec. AUC LR sens.spec.AUC LR sens.spec.AUC LR sens.spec.AUC LR sens.spec.AUC LRA 4293%87% 0.949 7.3 83%69%0.785 2.7 94%85%0.941 6.4 65%75%0.755 2.6 83%74%0.811 3.2A 42/A 40 ratio 93%87%0.947 7.3 93%84%0.900*5.8 99%83%0.936 5.9 85%85%0.893*5.5 90%82%0.903*5.1A 42, p-tau,t-tau 97%98%0.994‡45.6 93%96%0.963‡23.1 93%88%0.953 7.4 90%100%0.966‡n.c. 93%84%0.924 5.7A 42/A 40 ratio, p-tau, t-tau 93%98%0.980 43.5 91%96%0.957 22.8 99%79%0.936 4.7 90%100%0.970 n.c.87%90%0.923 9.0AD, Alzheimer disease; VaD, vascular dementia; FTD, frontotemporal dementia; DLB, dementia with Lewy bodies; non-AD, combined group of patients with VaD, FTD or DLB. Sens., sensitivity; spec., specificity; AUC, area under the ROC curve; LR, likelihood ratio; n.c., not computable.* p<0.01 compared to AUC for A 42 level.‡ p<0.05 compared to AUC for A 42/A 40 ratio.REFERENCES[1] McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stad-lan EM. 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6.间充质干细胞治疗脊髓小脑性共济失调_胡晶琼
Hu JQ, Ouyang WX, Li HY, Wang JF, Lu C, Zhang LN, Xu HB, Chen LL, Huang SA. Mesenchymal stem cells for the treatment of spinocerebellar ataxia. Zhongguo Zuzhi Gongcheng Yanjiu. 2013;17(27):5019-5025.
胡晶琼☆，女，1974 年生， 湖北省武汉市人，汉族， 2004 年德国弗莱堡大学 分子医学系医学博士毕 业，美国国家卫生研究院 博士后，副教授，主要从 事细胞治疗方面的研究。 j协和医院口腔 医疗中心，湖北省武汉市 430022
Received: 2012-10-02 Accepted: 2012-12-20
ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH
5019
胡晶琼，等. 间充质干细胞治疗脊髓小脑性共济失调
骨科词汇
医学词汇Ankle: Achilles Tendonitis 跟腱炎Ankle: Ruptured Achilles Tendon 跟腱破裂Ankle: Sprain 踝部扭伤Ankle Fracture 踝部骨折Ankylosing Spondylitis 关节黏连脊椎炎Aseptic Necrosis 无菌的骨疽Back Pain: Approach to Management 怎样处理背痛问题Back Pain: Prevention 预防背痛Baker's Cyst 贝勾氏囊Bones 骨骼的功能Bone Tumors 骨肿瘤Bunions 姆趾黏液囊肿大Carpal tunnel syndrome 腕管综合症Colles Fracture 桡骨下端骨折Compression Fracture of the Vertebrae 脊椎压迫性骨折Dislocation 脱臼Dupuytren Contracture 掌挛缩病Elbow: Golfer's Elbow 高尔夫球肘Elbow: Tennis Elbow 网球肘Fibromyalgia 纤维组织肌痛Flat Foot 扁平足Foot: Hammer Toe 锤状趾Foot: Plantar Fasciitis 足底筋膜炎Foot: Ulcers 脚溃疡Fracture 骨折Fracture: Bones in the Foot 脚部骨折Fracture: Clavicle 锁骨骨折Fracture Types 骨折的种类Frozen Shoulder 凝肩Ganglion 腱鞘囊肿Hand Fracture 手骨折Hand: Tenosynoritis 手部腱鞘滑膜炎Heel Spurs 脚跟骨刺和发炎Herniated Disk 椎间盆后凸Hip: Arthritis of the Hip 髋关节炎Hip and Knee Replacement 髋关节和膝关节置换手术Hip Fracture 髋部骨折Infectious Arthritis 感染性关节炎Joints 关节Knee: Arthritis 膝关节炎Knee: Joint Pain 膝关节痛Knee: Runner's Knee 跑步者膝盖Knee: Torn Ligaments 膝韧带撕裂Knee: Torn Meniscus Cartilage 半月板软骨撕裂Knee Pain: Injury, Degeneration & Arthritis 劳损、退化与膝盖关节炎Knee Pain and Shoes 膝关节痛与鞋子Knee Replacement: Surgery Can Relieve Pain 膝关节置换术：手术舒缓痛楚Kyphosis 脊柱后弯Leg Cramps 小腿抽筋Lumbar Herniated Disc 腰椎盆脱出Mallet Finger 锤状指Morton Neuroma 莫耳通氏神经瘤Muscles 肌肉Muscular Dystrophy 肌肉萎缩症Neck: Osteoarthritis 颈骨性关节炎Neck: Whiplash Injury 撞车引致的颈部扭伤Neck: Wry Neck 颈部僵硬Osteoarthritis 骨关节炎(退化性关节炎) Osteomalacia 软骨病Osteomyelitis 骨髓炎Osteoporosis 骨质疏松症Paget Disease 柏哲德氏病Ribs & Cartilage Inflammation 肋与软骨炎RICE Therapy RICE治疗法Rotator Cuff Injury 旋转肌边创伤Sciatica 坐骨神经痛Scoliosis 脊柱侧凸Scoliosis 脊柱侧弯Shin Splints 胫纤维发炎Shoulder: Dislocation 肩脱位Shoulder: Rotator Cuff Tear 轴转肌撕裂Shoulder: Tendinitis & Caspulitis 肩部腱炎和囊炎Spinal Stenosis脊柱狭窄Swollen Legs, Ankles, or Feet 腿、踝或脚肿胀Tendinitis, Tenosynovitis and Bursitis 腱炎、腱鞘炎和黏液囊炎Trigger Finger 弹机状指骨科专业英语Abduction splint 外展石膏Absorbable screws 可吸收螺钉Acetabulum 髋臼Amputation 截肢Analgesic 止痛药Ankle clonus 踝阵挛Ankylosing spondylitis 强直性脊柱炎Annulus 纤维环Arthroscopy 关节镜检查Asteofascial compartment syndrome 骨筋膜室综合症Atrophy of quadriceps femoral 股四头肌萎缩Avascular necrosis ofAvascular necrosis (A VW) 缺血性坏死Bathesthesia 深感觉Bilateral femoral head 双股骨头缺血坏死Bone traction 骨牵引Bowel and bladder dysfunction 二便障碍Brachial plexus anesthesia 臂丛麻醉Bunion 拇囊炎Capitula fibula 腓骨小头Cerclage (骨折端)环扎法Cerclage bandage 环形绷带Cerebral hemorrhage 脑出血Cerebral thrombosis 脑血栓Cervical spondylosis 颈椎病Clavicle fracture 锁骨骨折Closed suction drains 闭式引流Colle’s Fracture 科雷氏骨折Comminuted fracture of left** 左***粉碎性骨折Comminuted open fracture of talus 距骨的开放粉碎骨折Common peroneal nerve 腓总神经Congenital kyphoscoliosis 先天性侧后凸畸形congenital scoliosis 先天性脊柱侧凸Conscious mind 神志清楚Continuous epidural anesthesia （连）硬外麻Contracture of both 臀肌挛缩Core compression 髓芯减压术Crossed kirschner fixation 交叉固定DAS 动力型髋螺丝钉Debridement 清创Deformity 畸形Defuts of segmentation 分布障碍Decompression 减压Decompression of spinal canal 椎管减压Diastematomyelia 脊髓纵裂Discectomy 椎间盘摘除Discectomy of hemivertebrae 半椎体切除Dislocation 脱位DM 糖尿病Dorsal artery of foot 足背动脉Elastic fixation 弹性固定End vertebra 端椎Extension 伸External fixture 外固定Emergency case 急诊病例Faciotomy 筋膜切除术Femoral neck 股骨颈Femoral neck fracture 股骨颈骨折Figure of 8 bandage 8字绷带Flexion 屈曲Forklike deformity 餐叉样畸形Fracture 骨折Fracture of alner bone 尺骨骨折Fracture of calcaneus 跟骨骨折Fracture of distal phalange 远端趾骨骨折Fracture of distal radius 桡骨远端骨折Fracture of femoral neck 股骨颈骨折Fracture of great tubercle 肱骨大结节骨折of humurusFracture of proximal femor 股骨近端骨折Fracture of phalange 指骨骨折Fracture of radius 桡骨骨折Fracture of the base ofFracture of the scaphoid 舟状骨骨折Fracture of the ulna 尺骨骨折Fracture of ulna ocleranon 尺骨鹰嘴骨折General anesthesia 全麻General surgical 基本外科Gleniod fossa 关节盂Gluteal musclesGreater tuberosity 大结节Helo-pelvis 头颅环-骨盆环Hallux valgus 拇外翻Hallux varus 拇内翻High fever 高热Hilgenreiner’s angle 髋臼指数(acetabular index)Hemopneumothorax 血气胸Humeral head 肱骨头Humeral shaft fracture 肱骨干骨折Hypertrophy of facet 小关节增生肥大Hypoesthesia 感觉减退Ice bag 冰袋In right elbow joint 右肘肿物切除Incomplete paraplegia 不全瘫Injection 肌肉注射Interbody 椎间体Interlocking medullary mailing 带锁髓内针Intermittent claudication 间歇跛行Internal fixation 内固定术Intertrochanteric fracture 粗隆间骨折Intramscular hematoma 肌间血肿Intrumedullary needleJonalgia 膝痛Kyphoscoliosis 侧后凸Kyphosis 脊柱后凸laminectomy 椎板切除术Lateral meuleouls 外踝lipoma 脂肪瘤Local anesthesia 局麻Lodorsis 脊柱前凸Lower limb (extremuty) 下肢Mc Murrag’s test 麦氏实验Medial malleouls 内踝Metacarpophalangeal joint 掌指关节Metastaluc tumor 转移癌metastatic 转移瘤Metatarsalgia 柘骨痛Metatarsal fracture 跟骨骨折Myelogram 脊髓造影Nifedipine 心痛定Nitroglyccerin 硝酸甘油Numbness 麻木Old fracture 陈旧性骨折Osteoarthritis 骨关节炎Osteochondrdoma 软骨瘤Osteomyelitis 骨髓炎Paralytic scoliosis 麻痹性脊柱侧弯Paraplegia 截瘫Patellar fracture 髌骨骨折Pathologie diagnosis 病理诊断pediculate 椎弓根PercutaneousPhlebothrombosis 下肢静脉血栓Pilon fracture 胫腓骨下端骨折Plaster slab 石膏托Poliomyelitis 脊髓灰质炎Posterior malleolus fracture 后踝骨折Posterior malleolar fracture 后踝骨折Protrusion of intervertebral 腰椎间盘突出Protrusion of intervertebral disc 腰椎间盘突出Prolapsed intervertebral disc 椎间盘脱出Pubic symphysis 耻骨支Pulmanary function 肺功能Pulpous nuclear 髓核Radial head fracture 桡骨头骨折Radius and ulna 尺、桡骨Reduction by leverage 撬拨复位Regular operation 常规手术Resection of the massSacroiliac 骶髂关节Scholiosis 脊柱侧弯Sciatica 坐骨神经痛Sciatica 坐骨神经痛Sequela of poliomyelitis 小儿麻痹（脊髓灰质炎）后遗症Sinus tract 窦道Skin traction 皮牵引Sling(Triangular bandage) 悬吊（三角巾绷带）Spatula 压舌板Spinal stenosis 椎管狭窄Spondylolisthesis 脊柱滑脱Spondylolisthesis of lumber L4-5 L4-5脊柱滑脱Spondytolysis 蛱部裂Staticfixation 静力性固定Stenosis of Spinal Canal 椎管狭窄Stenosis of the lumbar spine 腰椎管狭窄Sublimation/semiluxation 半脱位Subluxation of ankle joint 踝关节半脱位subtrochanteric fracture 粗隆下骨折supracondylar fracture 踝上骨折suture stitch 缝针synovial membrance 滑膜Syringomyelia 脊髓空洞症Taction 触觉Tension band wire 张力带钢丝Tension bond 张力带Tetraplegia / quadriplegia 四肢瘫The fifth metacarple bone 第五掌骨基底骨折Thermesthesia 温度觉Tibia-talus semidislocation 半脱位Tibial fracture 胫骨骨折Tibial plateau fracture 胫骨平台骨折Total knee arthroplasty 全膝置换Total hip arthroplasty 全髋置换Trimalleolar fracture 三踝骨折Urinary incontinence 尿失禁Valgus muscle strength 外翻肌力Veterbera fracture 椎体骨折肌肉骨骼系统疾病英语翻译 [Musculoskeletal Disorders]背痛 backache臂骨脱臼 dislocated shoulder断骨节 dislocation风湿热 rheumatic fever风湿性关节炎 rheumatoid arthritis风湿症 rheumatism腐骨 sequestrum [dead brokenoff bone]跟腱挛缩 achilles tendon contracture骨关节炎 osteoarthritis; degenerative joint disease骨瘤 bone tumor; osteoma骨膜炎 periostitis [periosteum inflammation] 骨髓炎 osteomyelitis骨炎 osteitis [bone inflammation]骨原性肿瘤 osteogenic sarcoma骨折 bone fracture骨质软化症 osteomalacia [adult deficiency bone disease]关节脱位 dislocation of joint关节炎 arthritis滑囊炎 bursitis化脓性关节炎 suppurative arthritis神经系统英语翻译 [Neurological Disorders]半身不遂 right-side paralysis; hemiplegia; left-side paralysis部分麻痹 paresis; local paralysis颤抖 tremors抽搐 tic抽筋 spasm; clonus; jerkiness; minor muscular convulsion; convulsion; cramp打嗝儿 hiccup; hiccough大脑麻痹 cerebral paralysis; cerebral apoplexy大脑性瘫痪 cerebral palsy大脑炎 cerebritis; encephalitis单瘫 monoplegia; monoparesis点头病 nutation [uncontrollable nodding of the head]多发性硬化 multiple sclerosis亨丁顿氏舞蹈病 Huntington's chorea昏睡 coma肌肉萎缩 muscular atrophy急惊风 severe convulsion急性脑症 acute brain syndrome脊髓受伤 spinal cord injury脊髓受压迫 spinal cord compression脊柱裂伤 spina bifida人格缺陷疾病英语翻译 [Personality Disorders]被动侵略型个性passive-aggressive personality被动型个性passive personality不适应个性inadequate personality不喜社交型个性sociopathic personality; antisocial personality多重性格multiple personality攻击性个性aggressive personality精神变态psychopathic personality偏执型个性paranoid personality强迫观念及强迫行为型个性obsessive-compulsive personality侵略性个性aggressive personality人格分裂split personality双重人格split personality退缩型个性schizoid personality无能个性inadequate personality歇斯底里型个性hysterical personality; histrionic personality性别认同困惑disorder of gender-role identification心理缺陷疾病英语翻译 [Mental Defects]爱书癖 bibliophilism白日梦 day dreaming异装癖；异性装扮癖 transvestism暴露狂 exhibitionism受虐狂；被虐待狂 masochism藏书癖 bibliomania痴笑 silly laughter孤独症 autism孤癖 seclusion精神错乱 delirium夸大妄想狂 megalomania窥视狂 voyeurism恋兽狂 bestiality恋童狂 pedophilia恋物狂 fetishism虐待狂 sadism偏执狂 partial insanity破坏欲 thanatos迫害妄想狂 insanity of persecution窃盗狂 kleptomania精神疾病英语翻译 [Psychiatric Disorders]癌症恐惧症 cancerphobia爱恨交集 ambivalence被迫害妄想症 persecutory delusion被污恐惧症 mysophobia [fear of uncleanliness]病态死亡恐惧症 thanatophobia不洁恐惧症 mysophobia [fear of uncleanliness]部分性健忘症 partial amnesia产后抑郁症 postpartum depression乘坐飞机恐惧症 aviophobia痴呆症 dementia初老痴呆 pre-senile dementia初老错乱症 pre-senile dementia错乱症 dementia电子电器恐惧症 anoraknophobia动物恐惧症 zoophobia独语症 monologism同性恋者恐惧症 homophobia对外国人无端仇视 xenophobia反应性精神病 reactive psychosis反应性忧郁精神病 reactive depressive psychosis中医疗法英语翻译 [Chinese Acupuncture]艾 moxa艾灸术 moxibustion拔毒 to draw out pus by applying a plaster to the affected part拔火罐 cupping; cupping glass沉 heaviness打开“禁区” to open up a "forbidden zone" 导致痛觉消失 to induce analgesia电针 galvanic acupuncture; acupuncture with electric stimulation耳针 auricular needling; ear acupuncture 恢复视力 to regain one's vision金针拔障术 traditional technique for couching cataracts枯痔疗法 necrosis therapy of haemorrhoids 留针 retention of the needle in the body 麻 numb; numbness埋线疗法 catgut embedding therapy梅花针 "plum-blossom" shaped needling面针 face acupuncture能治疗多种疾病 to cure a wide range of diseases捻针 to rotate the needle; to twirl the needle气功疗法 traditional Chinese breathing exercise; breathing technique therapy医学诊断英语翻译 [Diagnosis]Ｘ光检查X-ray examinationＸ线照片X-ray film; roentgenogramＸ线照相X-ray film taking; X-ray photography; radio-graphy把水银柱甩下去to shake the mercury down把体温计放在腋下to put the thermometer in the armpit白细胞white corpuscle白细胞计数white blood cell count白血球white blood cell; leukocyte; hemoleukocyte钡餐检查barium meal examination冰冻切片frozen section病灶focus病诊断为… to diagnose the case as ...查病房to make ward rounds; to go on rounds in the wards 常规检查routine examination常规尿分析routine urinalysis抽血to draw blood触诊palpation大便正常bowels to move all right大小便送化验室化验to send specimens of one's stool or urine to the laboratory肺照相to have an X-ray taken of one's lung医院处方略语英语翻译 [Prescription Abbreviation]必要时 S.O.S. [=if necessary]不得重配 non repetat [=do not repeat]滴 gt; gtt [pl.] [drop; drops]耳 aur. [ear]饭后 p.c.; pc [=after meals]饭后服用 p.c.; pc [=after meals]饭前 a.c.; ac [=before meals]饭前服用 a.c.; ac [=before meals]分 div. [=divide]服用法 Sig.; sig [=write on label]公分 gm [=gram]公毫 cg [=centigram]公丝 mg [=milligram]含漱剂 garg [=gargle]毫克 mg [=milligram]和 et [=and]混合剂 comp. [=compound]剂量 D. [=dose]继续使用 contin. [=let to be continued]加 add. [add; let there be added]医院治疗英语翻译 [Treatment]Ｏ型Group O按规定饮食进食to go on a diet按摩massage按摩疗法massotherapy拔牙to have a tooth pulled out; to have a tooth extracted 半流质semi-liquid diet半流质食物semi-liquid diet包扎创伤to dress a wound保持大便通畅to keep one's bowels open保守疗法conservative treatment饱食后on a full stomach鼻饲法nasal feeding必要时服to take when necessary扁桃体切除术tonsillectomy表皮epidermis病复发to recur; recurrence of a disease; to have a relapse病号饭patient's diet; special food for patients病理切片pathological section病情恶化to take a change for the worse; to deteriorate病情好转to take a change for the better; to improve疾病症状英语翻译 [Symptom]柏油状大便 to pass tarry stools背痛 to have a pain in the back鼻涕 mucus in the nose; mucus from the nose; snivel鼻子不通 to have a stuffedup nose便秘 constipation; astride病情 state of an illness; patient's condition病情公报 medical bulletin病容 sickly look; to look ill; to look unwell 病危 critically ill; terminally ill充血 hyperemia; congestion; injection出现黄疸 to be jaundiced; to have jaundie 出疹子 to come out in a rash打喷嚏 to sneeze大便不正常 irregular bowel movement大便困难 to have difficulty in passing one's motions大便如何 How are the bowels大便失禁 incontinence of feces; be unable to hold one's motions大便四次 to have four motions胆固醇不正常 to have an abnormal blood cholesterol level盗汗 night sweat病理化验英语翻译 [Clinical Procedures]１７酮拟酯醇检验 17-ketosteroid analysis Ｃ－反应蛋白试验 C-reactive protein test 白喉杆菌鉴定 identification of Corynebacterium diphtheriae [diphtheria bacterium]白血球分类 white blood cell-classification; WBC-classification冰冻切片检查 frozen section病理检验 pathology examination肠病原体 intestinal pathogens沉淀物检查 sediment examination大便检验 routine stool analysis胆醇酯测定 cholesterol ester detection胆红素测定 bilirubin detection 电泳法 electrophoresis耳鼻喉科检查 ENT [ear, nose and throat] examination耳朵排出物检查 ear discharge examination 二氧化碳含量分析 CO2 content analysis饭后葡萄糖 analysis of glucose level after eating饭前葡萄糖 analysis of glucose level before eating非蛋白氮测定 NPN [non-protein nitrogen] detection肥达威氏飞氏试验 Weil-Felix reaction;Weil-Felix test [bacterial test]肺功能 pulmonary function诊断治疗就医英语翻译 [Diagnosis & Treatment病假条 certificate for sick leave病历 case history; medical record病例 case病史 medical history初诊 first visit; first consultation出院 to be out of hospital; to be discharged from hospital出诊 to visit; to pay a call; to be called out on a case复诊 subsequent visit; subsequent consultation给病假两周 to give a sick leave of two weeks; to grant two weeks' sick leave挂号 to register急诊 emergency case; emergency treatment 叫下一个病人进来 to have the next patient in 开诊断书 to make out a medical certificate 看病 to see a doctor; to consult a doctor 看医生 to see a doctor; to consult a doctor 临床表现 clinical manifestation临床观察 clinical observation门诊时间 consulting hours请病假 to ask for sick leave请医生 to send for a doctor,医药器材英文翻译 [Equipment & Material]Ｔ字杖 crutchＸ光底片 X-ray filmＸ光透射床 radiolucent bedＸ光照片 roentgenogram; radiographＸ光装置 X-ray apparatus爱密扫描仪 EMI-scanner拔毛镊 forceps; epilation forceps; tweezers 拔牙器 tooth extractor白金钉牙 platinum pin pivot白衣 lab coat拌药刀 spatula备用病床 available sick bed绷带 bandage鼻镜 rhinoscope扁桃腺缝针 tonsil suture needle冰袋 ice pack冰帽 cold pack产钳 obstetrical forceps车牙石 carborundum [as a polish]持骨钳 bone clamp; bone forceps医院科室英文翻译 [Departments]Ｘ光室X-ray room病房patient ward病理化验室pathology laboratory病理科pathology department产房delivery room产科病房obstetrical ward; maternity ward齿内治疗科endodontic therapy传染病房lazaretto ward [quarantine]传染病科infectious diseases specialty传染病院infectious disease hospital待运站stockroom; holding station耳鼻喉科ear, nose and throat specialty; otolaryngology; ear-nose-throat department; ENT department放射科X-ray department放射线科radiology; radiology department肺功能室pulmonary function lab肺结核病房tubercular ward肺结核病科pulmonary tuberculosis department; pulmonary tuberculosis specialty妇产科obstetrics & gynecology maternity; obstetrics & gynecology department肝病检查室hepatology高压舱recompression chamber; hyperbaric chamber,各类医院英文翻译 [Hospitals]麻风院asylum for lepers; leper house; hospital for lepers; leprosarium产科医院lying-in hospital; maternity hospital传染病医院hospital for infectious diseases; infectious hospital儿童医院children's hospital防疫站quarantine station 疯人院lunatic asylum附属医院affiliated hospital妇产科医院maternity; obstetrics and gynecology hospital 隔离医院isolation hospital后方医院base hospital; rear hospital性病医院hospital for venereal diseases基地医院base hospital急救站first-aid station检疫站quarantine station保健中心health center卫生院health center卫生所health center社区医院community hospital结核病医院tuberculosis hospital精神病院mental home; mental hospital; psychiatric hospital; lunatic asylum; sanitarium; asylum先天遗传病英语翻译 [Genetic & Congenital Disorders]矮小女人female midget矮子midget凹胸hollow-chested凹眼deep-set eyes白痴idiot白公病albinism白化病albinism半病人semi-invalid半废人semi-disabled半阴阳hermaphrodism半肢畸形hemimelia [congenital contractures of the limbs] 膀胱外翻ectopia vesicae [bladder displacement]膀胱异位ectopia vesicae [bladder displacement]暴牙bucktooth苯酮尿症phenylketonuria残废deformation; deformity; maimed; disablement残废者disabled person; the handicapped痴呆cretin; gawk痴肥obesity粗腿thick-legged; thick leg内分泌疾病英语翻译 [Endocrine & Nutritional Disorder]艾迪生氏病 Addison's disease不孕症 infertility成分不够 element deficiency代谢异常症 metabolic anomaly蛋白质缺乏 protein deficiency低血糖 hypoglycemia饿虚 inanitation; general starvation肥胖症 obesity; adiposity分泌过多 hypersecretion副甲状腺功能不良 parathyroid dysfunction 肝炎 hepatitis肝硬化 cirrhosis; cirrhosis of liver坏血病 scurvy [ascorbic acid deficiency] 肌氨酸尿血症 creatinuria甲状腺机能减退 hypothyroidism甲状腺亢进 hyperthyroidism甲状腺类疾病 thyroid disorder甲状腺炎 thyroiditis甲状腺肿 goiter脚气病 beriberi [vitamin B deficiency]; athlete's foot其它常见疾病英语翻译 [Other Disorders]阿都司氏型反应 arthus-type reactions鼻咽癌 malignant tumor of nasopharyngeal passages变应性 hypersensitivity; allergy表皮灼伤 superficial burn病毒转移 metastasis [tumor cell translocation and growth]擦伤 chafe迟缓型过敏 delayed-type hypersensitivity 触电 electric shock刺伤 punctured wound挫伤 contusion弹伤 bullet wound刀伤 cut第二级烧伤 second-degree burn第三级烧伤 third-degree burn第一级烧伤 first-degree burn电击 electric shock电烧伤 electrical burn跌伤 fall wound冻疮 frostbite; frostnip冻伤 frostbite; frostnip,呼吸系统疾病英语翻译 [Pulmonary Disorders]肺癌 lung cancer肺部纤维变性 pulmonary fibrosis肺部职业病 occupational lung diseases肺过敏 lung hypersensitivity disease肺呼吸困难 pulmonary dyspnea肺坏疽 gangrene of lung肺结核 pulmonary tuberculosis肺扩张不全 pulmonary collapse肺瘤 lung tumor 肺脓肿 pulmonary abscess肺气肿 pulmonary emphysema肺水肿 pulmonary edema; lung edema肺无力 respiratory failure; pulmonary insufficiency肺血管阻塞症 pulmonary embolism肺炎 pneumonia黑肺病 miner's lung; black lung disease呼吸道出血 respiratory tract bleeding呼吸衰竭 respiratory failure; pulmonary insufficiency呼吸系统疾病 pulmonary disorder换气过度症 hyperventilation syndrome心血管系统疾病英语翻译 [Cardiovascular Disorders]闭塞动脉症 occlusive arterial disease出血性紫斑 hemorrhagic purpura大动脉炎 aortitis大脑出血 cerebral hemorrhage低血压 low blood pressure; hypotension动脉瘤 aneurysm动脉末梢疾病 peripheral arterial disease 动脉硬化症 arteriosclerosis动脉粥状硬化 atherosclerosis风湿性心肌炎 rheumatic myocarditis风湿性心脏病 rheumatic heart disease高血压 high blood pressure; hypertension 冠状动脉阻塞 coronary artery occlusion急性心肌炎 acute myocaraditis继发性心脏病 secondary heart disease静脉曲张 varicose veins静脉血栓及血栓静脉炎 venous thrombosis & thrombo phlebitis静脉炎 phlebitis脉管闭合 vascular occlusion慢性狭窄性心包炎 chronic constrictive pericarditis泌尿系统疾病英语翻译 [Renal & Urogenital Disorders]膀胱结石 vesical calculus [bladder stones] 膀胱炎 bladder cystitis睾丸炎 orchitis [testicular infection]不痛结石 silent stone草酸钙石 calcium oxalate stones蛋白尿 proteinuria毒性肾病 toxic nephrosis多囊性肾病 polycystic renal diseases多尿症 polyuria [excessive urine output]龟头炎 balanitis急性肾衰竭 acute renal failure急性肾脏炎 acute nephritis精囊炎 spermatocystitis慢性肾衰竭 chronic renal failure泌尿生殖器官损伤 genitourinary trauma泌尿系统疾病 renal and urogenital disorder 尿道膀胱炎 urinary tract infection; urethrocystitis尿道感染 urinary infection尿道炎 urethral infection; urethritis尿毒症 urinemia [anemia with renal dysfunction]消化系统疾病 [Gastrointestinal Disorders]阿米巴痢疾 amebic dysentery扁桃体炎 tonsillitis扁桃腺炎 tonsillitis便闭 constipation便秘 constipation肠癌 cancer of the intestine肠梗阻 intestinal obstruction肠热病 typhoid fever肠炎 enteritis [intestinal inflammation]大便失禁 fecal incontinence腹股沟疝 inguinal hernia [in groin area]腹膜炎 peritonitis [peritoneum inflammation] 急性阑尾炎 acute appendicitis急性盲肠炎 acute appendicitis急性胃炎 acute gastritis寄生虫病 gastrointestinal parasitism夹层动脉瘤 dissecting aortic aneurysm结肠切开术 colotomy结肠炎 colitis结肠造口术 colostomy皮肤病英语翻译 [Skin Disorders]疤痕 scar白斑 leucoma斑点 macule斑纹 macule剥脱性皮炎 exfoliative dermatitis扁平苔癣 lichen planus表皮糜烂 epidermal erosion糙皮病 pellagra臭汗症 osmidrosis [foul sweat] 带状疱疹 herpes zoster; shingles丹毒 erysipelas; St Anthony's fire冻疮 chilblains; frostbite冻疮化脓 abcessed frostbite冻疮疱 frostbite bulla; frostbite blister 痘疮 pock毒疮 carbuncle多汗症 excessive sweating; hyperhidrosis 多毛 hirsutism多形红斑 erythema multiforme恶性水肿 malignant edema,儿科疾病英语翻译 [Childhood Disorders]肠管内异物 foreign body in the intestinal tract肠套叠 intussusception; intestinal intussusception成长障碍 growth disorder出生损伤 birth injury [newborn]大脑性瘫痪 cerebral palsy蛋白质缺乏症 protein malnutrition; kwashiorkor低血糖症 hypoglycemia发作性心房心动快速 paroxysmal atrial tachycardia格鲁布 croup骨炎及软骨炎 Legg's disease脊髓灰质炎 poliomyelitis; infantile paralysis结核性软脑膜炎 tuberculous meningitis巨体畸形 macrosomia [newborn]莱格氏病 Legg's disease麻疹 measles脑下腺或肾上腺官能不足 pituitary or adrenal insufficiency尿崩病 diabetes insipidus尿布疹 diaper rash; diaper dermatitis热病猝发 febrile seizures腮腺炎 mumps。
产科镇痛方式选择与并发症
影响轻于单次或持续蛛网膜下腔阻滞，如局部麻醉药（ＬＡ） 复合小剂量阿片类药物，则对产妇或新生儿呼吸抑制程度可 能轻于单次或持续蛛网膜下腔阻滞，但无多中心研究或流行 病学调查证实。其缺点为：（１）ＬＡ用量大，易致中枢神经与 心血管系统毒性反应。（２）如误注入血管可致惊厥、昏迷及 心血管虚脱、心搏骤停。（３）起效慢，不能满足疼痛剧烈或产 科急诊镇痛的需要。（４）可出现阻滞不完全或阻滞平面达不 到Ｔ５～ｓ５，甚至阻滞失败。（５）产科镇痛涉及Ｓｌ或Ｓ１～Ｓ３脊 神经，而此节段脊神经最易发生阻滞不完善，机理目前尚不 明了，单纯硬膜外给予ＬＡ难以完全阻滞ｓｌ～Ｓ脊神经，易
［７３ ［６３
ＵＫ
ｐｒａｔｉｃｅ．
［５３
Ａｒｋｏｏｓｈ ＶＡ，Ｐａｌｍｅｒ ＣＭ，Ｙｕｎ ＥＭ，ｅｔ ａ１．Ａ ｒａｎｄｏｍｉｚｅｄ ｄｏｕｂ—
ｌｅ—ｍａｓｋｅｄ，Ｍｕｈｉｃｅｎｔｅｒ ｃｏｍｐａｒｉｓｏｎ ｏｆ ｔｈｅ ｓａｆｅｔｙ ｏｆ ｃｏｎｔｉｎｕｏｕｓ
ｉｎｔｒａｔｈｅｃａｌ
ｌａｂｏｒ Ａ１１ａｌｇｅｓｉａ
可见其应用优势。ＰｒｅｓｔｏｎＥ９］在加拿大麻醉学杂志编者按中 指出，ＣＳＥ将ＬＡ复合小剂量阿片类（倡导应用芬太尼或舒 芬太尼）药物用于产科分娩镇痛，其优势超出持续硬膜外或 持续蛛网膜下腔阻滞，并提议在ＣＳＥ镇痛中不宜使用布比 卡因。ＣＳＥ的优点为：（１）分娩镇痛起效快；（２）效果完善，更 易发挥硬膜外导管的优势；（３）可保留硬膜外阻滞行走性分 娩镇痛坤Ｊ。 小剂量阿片类药物在产科镇痛中的应用 产科采用
９
１８］。
５．其他并发症：产科患者硬膜外镇痛血肿发生率为 １／１６８ ０００，硬膜外深部感染为１／１４５ ０００Ｃ１５］；蛛网膜下腔阻 滞后脑膜炎发病率为１／４３ ０００，硬膜外阻滞后脊髓血管栓塞 或痉挛为１／３７
椎管内麻醉-Intrathecal-Anesthesia
(轻比重)
by the addition of sterile water.
Isobaric solution: It is nearly equal to gravity of CSF, and it is
(等比重)
mixed with CSF(at least 1:1).
(The gravity of CSF is 1.003～1.009)
2. 间接作用(全身影响): Indirect actions(systemic effects)
★ Cardiovascular manifestations——心血管系统影响
vasodilation of venous capacitance vessels
Sympathetic Nf block
一、概述(outline)
平面：According to the level of neural blockade
high position: The sensory blockade ＞T4
Spinal anesthesia mid position: The sensory blockade≤T5—9
( 二) 禁忌证(contraindications)
➢ Relative contraindications
Sepsis Uncooperative patient Preexisting neurological deficits Demyelinating lesions Stenotic valvular heart lesions Severe spinal deformity
▲Procaine：procaine 150mg+csf2.7ml or + 5%G.S 2.7ml+0.1%Adr0.3ml.
腰硬联合麻醉穿刺流程
腰硬联合麻醉穿刺流程英文回答：Lumbar Epidural and Spinal Anesthesia.Procedure:Patient positioning: Patient is typically positioned in the lateral or sitting position with the spine flexed, creating a wider epidural space.Skin preparation and local anesthesia: The skin over the lumbar puncture site is shaved and sterilized. Local anesthesia is injected to numb the area.Epidural space identification: A Touhy needle is inserted through the skin using a loss-of-resistance technique to locate the epidural space. The needle bevel is facing cephalad.Epidural catheter insertion: A catheter is threaded through the Touhy needle and advanced into the epidural space approximately 5-10 cm.Epidural medication administration: Local anesthetic or opioids can be administered epidurally for pain management.Spinal anesthesia: In this technique, a smaller-gauge spinal needle is used to puncture the dura mater and access the subarachnoid space. A small amount of local anesthetic is injected into the cerebrospinal fluid. Spinal anesthesia provides faster onset but shorter duration of analgesia compared to epidural anesthesia.Monitorization: Vital signs and sensory and motor function are closely monitored throughout the procedure and recovery period.Benefits:Provides effective pain relief during surgery orchildbirth.Allows for a more awake and interactive patient experience.Can reduce the risk of complications associated with general anesthesia.Risks:Hypotension.Nausea and vomiting.Headache.Nerve damage.Infection.Transient neurological symptoms.Contraindications:Coagulopathy.Active infection at the puncture site.Severe spinal deformity.中文回答：腰硬联合麻醉穿刺流程。
医学英文缩写一览表之欧阳法创编
医院日常用品、设备英文单词•Stethoscope[听诊器]•Sphygmomanometer (Blood pressure gauge)[血压计]•Thermometer[体温表]•Tongue depressor (spatula)[压舌板]•Needle[针头]•Syringe[注射器]•Cotton stick (ball)[棉签（球）]•Bandage[绷带]•Elastic bandage[弹力绷带]•Esmarch`s bandage[橡皮绷带]•Tourniquet[止血带]•Gauze[纱布]•Adhesive plaster[橡皮膏]•Dressing[敷料]•Splint[夹板]•Rubber glove[橡皮手套]•Sand bag[沙袋]•Ice bag[冰袋]•Hot water bottle[热水瓶]•Bedpan[便盒]•Urinal[尿壶]•Catheter[导尿管]•Rectal tube[肛管]•Dilator[扩张器]•Gastric tube[胃管]•Lavage tube[洗胃管]•Oxygen tube (cylinder)[吸氧管]•Sengstaken-Blakemore tube[三腔二囊管]•Visual testing chart[视力表]•Incubator[保温箱]•Plaster bed[石膏床]•Sheet[被单]•Bedding[被褥]•Blanket[毛毯]•Diaper[尿布]•Pillow case[枕套]•Bedside table[床头柜]•Towel[毛巾]•Basin[脸盒]•Comb[梳子]•Tooth-paste[牙膏]•Tooth-brush[牙刷]•Rubber cushion[橡皮圈]•Air cushion bed[气垫床]•Scale[台秤]•Flashlight[电筒]•Scissors[剪刀]•Tray[托盘]•Sputum cup[痰杯]•Test tube[试管]•Infusion support[输液架]•Infusion drip monitor[输液滴速监护仪]•Micropump[微泵]•Operating table[手术台]•Shadowless lamp[无影灯]•Slit lamp[裂隙灯]•Scalpel[手术刀]•Silk sutures[丝线]•Rubber drainage[引流管]•Operating gown[手术衣]•Overalls[工作服]•Operating sheet[手术床单]•Mask[口罩]•Hemostatic forceps[止血钳]•Needle forceps (holder)[持针钳]•Dressing forceps[敷料钳]•Smooth forceps[无齿镊]•Tissue forceps[组织镊]•Anesthesia machine[麻醉机]•Electrocardiograph[心电图机]•X-ray machine[X 线机]•Ventilator[呼吸机]•Suction[吸引器]•Tractor[牵引器]•Rescue carrigae[抢救车]•Stretcher[担架]•Bedside monitor[床边监护仪]•Defibrillator[除颤仪]•Ambulance[救护车]•Pacemaker[起搏器]•Hyperbaric oxygen chamber[高压氧仓]•Otoscope[耳镜]•Rhinoscope[鼻镜]•Ophthalmoscope[眼底镜]•Esophagoscope[食道镜]•Bronchofiberscope[纤支镜]•Gastrofiberscope[纤维胃镜]•Proctoscope[直肠镜]•Peritoneoscope[腹腔镜]•Sigmoidoscope[结肠镜]•Cystoscope[膀胱镜]•Microscope[显微镜]•Thoracentesis set[胸穿包]•Lumbar puncture set[腰穿包]•Bone marrow puncture set[骨穿包]•Abdominocentesis set[ [腹穿包]•Venosection set[静切包]•Transfusion set[输血包]•Refrigerator[冰箱]•Microwave oven[微波炉]•Blood pressure monitor[血压监护仪]•Automatic blood pressuremeter( ABPM)[自动血压机]医学英文缩写一览表【单词缩写】aa.-of each[各]•Ab.-antibody[抗体]•abd.-abdomen[腹部]•ABG-arterial blood gas[动脉血气]•abn.-abnormal[异常]•ABp-arterial blood pressure[动脉压]•Abs.-absent[无]•abstr.-abstract[摘要]•a.c.-beforemeals[饭前]•Ach.-actylcholine[乙酰胆碱]•ACH.-adrenal cortical hormone[肾上腺皮质激素]•ACT.-active coagulative time[活化凝血时间]•ACTH.-adrenocorticotripic[促肾上腺皮质激素]•ad.(add.)-adde[加]•ad effect.-ad effectum [直到有效]•ADH.-antidiuretic hormone[抗利尿激素]•ad lib-at liesure[随意]•adm.(admin)-adminstration[给药]•ad us est.-for external use[外用]•af.-atrial fibrillation[房颤]•aF.-atrial flutter[房扑]•A/G ratio.-albumin-globulin ratio[白-球蛋白比]•AIDS.-acquired immune deficiency syndrome[爱滋病]•al.-left ear[左耳]•alb.-albumin[白蛋白]•AM.-before noon[上午]•amb.-ambulance[救护车]•amp.(ampul)-ampoule[安瓿]•ANA.-anesthesia[麻醉]•anal.-analgesic[镇痛药]•ap.-before dinner[饭前]•appr.(approx.)-approximately [大约]•AR.-aortic regurgitation[主闭]•AS.-aortic stenosis[主狭]•ASA.-aspirin[阿斯匹林]•ASD.-atrial septal defect[房缺]•AST.-aspartate transaminase[谷草转氨酶]•atm.(atmos.)-atomsphere[大气压]•ATS.-antitetanic serum[抗破伤风血清]•av.-average[平均]•Ba.-Barium[钡]•BBT.-basal body temperature[基础体温]•BCG.-bacille Calmette- Guerin[卡介苗]•biblio.-biliography[参考文献]•bid.-twice a day[每日二次]• b.m.-basal metabolism[基础代谢]•Bp.-blood pressure[血压]•bpm-baets per minute[次/分]•BS.-blood sugar[血糖]•BW.-body weight[体重]•C.- centigrade[摄氏温度计]•CA.-carcinoma[癌]•Cal.-cancer[癌]•Cal. –calorie[卡]•Cap. –capsule[囊]• C.B.C-complete blood count[血常规]•CC.-chief complaint[主诉]•CC. list.-critical condition list[病危通知单]•CCU.- Coronary care unit[冠心病监护室]•CD.-caesarean delivered[剖腹产]•CDC.-calculated date of confinement[预产期]•CEA.-carcinoembryonic antigen[癌胚抗原]•CG.-control group[对照组]•CK.-creatine kinase[肌酸激酶]•Cl.-centilitre[毫开]•cm.-centimetre[毫米]•CNS.-central nervous system[中枢神经系统]•Co.-compound[复方]•contra.-contraindicated[禁忌]•CT.- computerizedtomography[计算机断层扫描]•C.V-curriculum vitae[简历]•DBp-diastolic blood pressure[舒张压]•DD.- differential diagnosis[鉴别诊断]•dept.-department[科]•diag.-diagonsis[诊断]•DIC-disseminate intravascular coagulation[弥漫性血管内凝血]•dl.-deciliter[分升]•DM.-diabetic mellitus[糖尿病]•DM.-diastolic murmur[舒张期杂音]•D.O.A-dead on arrival[到达时已死亡]•DOB.-date of birth[出生日期]•Dr.-doctor[医生]•DIW.-dextrose in water[葡萄糖液]•D-5-W,-5% dextrose in water[5%葡萄糖液]•DU-duodenal ulcer[十二指肠溃疡]•ECG.(EKG.)- electrocardiograph[心电图]•ECHO .-echogram[超声]•EDD.(EDC)-expected date of delivery (confinement) [预产期]•ENT. –ears, nose and throat[五官科]•EMG. –electromyogram[肌电图]•ER. – emergency room[急诊室]•et al.-and elsewhere[等等]•etc. –and so forth[等等]•F.(Fahr.)-Fahrenheit [华氏]•F- Female[女性]•F.B.S.- fasting blood sugar[空腹血糖]•FDP.-fibrinogen degradation products[纤维蛋白原降解产物]•FFA. – free fatty acid[游离脂肪酸]•FUO. –fever of unknown origin[不明原因发热]•FX. –fracture [骨折]•GH. –growth hormone[生长素]•GI.- gastrointestinal[消化]•GITS. –gastrointestinal therapy system[胃肠治疗系统]•gtt. –drops[滴]•GU.- gastric ulcer[胃溃疡]•Hb. –hemoglobin[血红蛋白]•HBp.-high blood pressure[高血压]•HCG. –human choroionic gonadotropic hormone[人绒毛膜促性腺激素]•HDL.- high density lipoprotein[高密度脂蛋白]•HR.-heart rate[心率]•ht.-height[身高]•HTN.-hypertension[高血压]•Hx.-history [病历]•Hypo.-hypodermic injection[皮下注射]•IABP.-intra –aortic balloon pacing[主动脉内囊反搏]•I/O.-intake and output [进出量]•ICU. – intensive care unit[重症监护病房]•ie. –that is [即]•Ig. –immunoglobulin[免疫球蛋白]•Im. –iutramuscular[肌内的]•INH.- inhalation[吸入]•INH.- isoniazid[异烟肼]•Inj.- injection[注射]•Int.- intern[实习生]•IP.- in-patient[住院病入]•Iu.-international unit[国防单位]•IV.-intravenously[静脉内]•J.- joule[焦耳][肾、输尿管和膀胱]•LBp.-low blood pressure [低血压]•LC. –laparoscopic cholecystectomy[腹腔镜胆囊切除术]•LDL.-Low density lipoprotein[低密度脂蛋白]•Liq. –liquid[液体]•LMP.- last menstrual period[未次月经]•LP. –lumbar puncture[腰穿]•M. –male[男性]•MCD.-mean corpuscular diameter[平均红细胞直径]•MCH.-mean corpuscular hemoglobin[平均红细胞血红蛋白量]•MCHC.-mean corpuscular hemoglobin concentration[平均红细胞血红蛋白浓度]•MCV.-mean corpuscular volume[平均红细胞体积]•MI.-myocardial infarction[心梗]•min.-minute[分]•mixt。
医疗护理常用英语交班
patient number, discharge, admission, change in, change out, death, primary care number, critical patient number,patient with caregiver, current number,专业英语常识一．Receiving the patient（接待病人）1. How do you do?/ Good morning!您好！（初次见面时使用）/早上好！2. What can I do for you?/Can I help you?您需要我帮助吗？3．I’ll bring you to your bedside, please follow me. This is your bed..我要领您到床边去.请跟我来.这是您的床位.4. The toilet is over there.卫生间在那边5.We supply hot water. 我们供应热水6.Please wait a moment. I’ll let your doctor know. /I’ll inform your doctor.请等一会儿,我去通知医生.7.Mary is the nurse /doctor in charge of you.玛丽是您的负责护士/医生8.Please let us know if you need any help. 您需要帮助时，请告诉我们.9.Smoking is not allowed here.这里不允许吸烟二.information collection(收集信息)10.Do you mind if I ask you a few questions? 您介意我问您几个问题吗?11.We need some information from you. 我们需要从您这儿收集一些信息.12.Is your tummy still sore? 您的肚子还疼吗?13.Does your pain come on after or before meals? 您的疼痛是在饭前还是饭后发作？14.Does it hurt to pass urine?/when I press here? 排尿时痛吗？/ 当我按压这儿时痛吗？15.Does your back ache? 您的后背痛吗？16.Do your feet swell?您的脚肿了吗？17.Do you have a cough/fever? 您咳嗽吗？/ 您有发热吗？18.Do you bring up any sputum? 您咳痰吗？19.Is there any radiation of the pain ? (to the shoulder)有放射（到肩部的）痛吗？20.How long have you had the pain? 您的痛有多长时间了？21.When did the pain start?/where is your pain? 疼痛从什么时候开始的/什么地方疼痛？22.Are your periods regular? 您的月经规则吗？三．Physical examination（查体）23.Will you please undress for medical examination? 请您脱下衣服做体检好吗？24.Take off your clothes, please. 请把衣服脱下来25.Lie down on the couch, please./Just lie still on the couch and relax.请躺在治疗床上./ 请安静地躺在治疗床上,放松.26.Bend your knees, please. 请屈膝.27.Open your mouth and say ‘ah” 张开口, 说: 啊28.Beathe deeply, please./take a deep breath, please.请深呼吸29.May I examine your tummy, please? 我要检查下您的肚子, 好吗?30.Roll up your sleeves, please. 请卷起袖子.四．communication.(交流)31.I am going to take your temperature./Please put the thermometer under your armpit.我要测一下您的体温/请把体温计放在您的腋下.32.Let me feel your pulse.让我测一下您的脉搏.33.I’ll test/take your blood p ressure. 我要测量您的血压.34. I’m afraid I have to prick your finger and take a drop of blood for blood sugar level.我要取一滴指血做血糖测定, 需要刺一下手指.35.I’ll take some blood from your arm now. 现在我要从您的胳膊抽血.36.Don’t take any thing by mouth after midnight until the blood is drawn tomorrow morning . 半夜之后不要吃喝任何东西，明天早上抽血.37.Please bring a specimen of your urine/stool/sputum./ please collect your mid-stream specimen of urine.请留一份尿/便/痰的标本/请收集您的中段尿.38.Please have your blood and urine tests done. 请做一下您的血和尿试验.39.You are going to have a CT-scan of your chest/head today.今天您要做一个胸部/头部CT.40.You are going to have a chest X-ray this morning. 今天早上您要拍一个胸片.41.You are going to have a B-mode ultrasonic exam. Please keep your bladder full.您要做B超检查,请留尿,使膀胱充盈.42.You are going to have an g astric endoscopy tomorrow morning. please don’t eat or drink anything after 12 o’clock tonight.明天上午您要做胃镜检查，今晚12点之后，请不要吃喝任何东西。
椎管内麻醉和神经阻滞
编辑课件
并发症
术中
• 全脊椎麻醉(total spinal anesthesia) • 血压下降: vasodilatation\ vagus nerve • 毒性反应 • 呼吸抑制 • 恶心、呕吐
术后
• 脊神经根损伤 • 导管拔出困难或折断 • 硬膜外血肿（epidural hematoma） • 硬膜外脓肿 • 脊髓前动脉综合征
局部麻醉(英文)
二、Spinal & Epidural Anesthesia
实用文档
Spinal & Epidural Anesthesia
• Anatomy • Technique • Factors affecting blocking region • ※ Complication • Indications & Contraindications
实用文档
实用文档
实用文档
Factors affecting blocking region
Spinal anesthesia Volume
Rate of injection Density of LA Patient’position
Epidural anesthesia Puncture Site Volume
epiduralanesthesian一nerveblocksdruglocalanestheticsservercomplicationthetoxicityoflaanatomyandtechniquelocalanestheticslalocalanestheticsla?十八世纪中人们咀嚼古柯叶感受舒适感和增加耐力?1860年从古柯叶中发现了可卡因?1884年可卡因先后用于眼部局麻手术颌神经阻滞脊髓麻醉硬膜外麻醉和蛛网膜下腔阻滞麻醉1884年可卡因先后用于眼部局麻手术颌神经阻滞脊髓麻醉硬膜外麻醉和蛛网膜下腔阻滞麻醉1905年发现普鲁卡因丁卡因利多卡因布比卡因普鲁卡因丁卡因利多卡因布比卡因等可卡因因其成瘾性高和安全性低而被淘汰
实用文档
Sciatic Nerve Blocks
实用文档
Surface landmarks
实用文档
常用医嘱术语(英文)
常用医嘱术语[Medical orders]（1）医嘱术语[medical orders]•Admit/transfer to[收入（转入）]•Resident/attending[住院（主诊）医师]•condition[病情]▲critical (Imminence)[病危]▲unstable[不稳定]▲stable[稳定]▲general (fair) [一般]•emergent[急诊]•Diagnosis[诊断]•Diet[饮食]▲full (home) diet[普食]▲l iquid (semi-liquid) diet[流汁（半流汁）饮食]▲soft diet[软食]▲low salt and low fat diet[低盐低脂饮食]▲salt-free diet[无盐饮食]▲low purine diet[低嘌呤饮食]▲low (non)-residue diet[少（无）渣饮食]▲light diet [清淡饮食]▲high caloric diet[高热量饮食]▲high protein (protein-rich) diet[高蛋白饮食]▲diab etic diet[糖尿病饮食]▲nephritic diet[肾炎饮食]▲nasal feeding[鼻饲]▲fasting (NPO, nothing by mouth)[禁食]▲NPO for 5 hours[禁食5小时]▲meal standard[伙食标准]•activity[活动]▲absolute rest[绝对卧床休息]▲stay on the bed (yest in bed)[卧床休息]▲Ad lib[随意活动]▲In the ward [病房内活动]•vital signs[生命体征]•Q shift (q.6h)[每班（每6小时）一次]•immoblization[制动]•pressed by sand bag [沙袋压迫]•I/O (intake and output)[记出入量]•N/A (non-apply)[不需要]•parameter: EKG(Bp,SaO2) monitor [其他：心电图（血压，氧饱和度）监护]•allergies[过敏]•NKA (non-known allergies)[无已知的过敏反应]•patient identification [病人身份]•4th floor,room 5 ,bed 2(405-2)[4楼5号房2床]•Med. Rec#[病历号]•medical orders[医嘱]•on general routine[护理常规]•on grade I (II, III) nuring care[I （I、III）级护理]•morning (evening) care[晨间（夜间）护理]•bedsore care[褥疮护理]•mouth (oral) care[口腔护理]•CP T( chest physical treatment) [胸部物理治疗]•O2 inhalation (2-4L/min)[吸氧（2-4升/分）]•alcohol sponge bath[酒精擦浴]•cold (hot) compress[冷（热）敷]•wet (hydropathic) compress by MgSO4[用硫酸镁湿敷]•change position × qh[每小时更换一次体位]•gastric lavage with water[用清水洗胃]•bladder irri gation [膀胱冲洗]•under water seal drainage of thorax[胸腔水封瓶引流]•GI decompression [胃肠减压]•keep warm[保温]医.学全在.线,提供ww w.m ed126.co m•lower temperature by ice-cap[冰帽降温]•keep bowels open[保持大便通畅]•keep the airway open[保持气道通畅]•retention catheterization[留置导尿]•prevent from bedsore[预防褥疮]•on bedside isolation[床边隔离]•P.P sitz bath[高锰酸钾液坐浴]•raising the head (foot) of the bed[抬高床头（尾）]•pencillin (procaine, iodine) skin test[青霉素（普鲁卡因，碘）皮试] •intubate and ventilator support[气管插管及呼吸机支持] •cleaning (retention) enama[清洁（保留）灌肠]•soapsuds (saline) enama[肥皂水（盐水）灌肠]•intradermal injection[皮内注射]•subcutaneous (hypodermic) injection [皮下注射] •intramuscular injection( i.m)[肌肉注射]•intravenous injection(i.v)[静脉注射]•intravenous drip(ivgtt)[静脉滴入]•intr aarterial injection[动脉注射]•intraarticular injection[关节内注射]•intrapleural injection[胸腔内注射]•intrathecal injection[鞘内注射]•intraspinal injection[椎管内注射]•per os(P.O,by mouth[口服]•inhalation[吸入]•inunction[涂擦]•scarification[划痕法]•by rectum[直肠灌注]•quaque die (q d)[一天1次]•bis in die(bid)[一天2次]•ter in die (tid)[一天3次]•quater in die (qid)[一天4次]•quaque hora (qh)[每小时1次]•quaque quarta hora(q4h)[每4小时1次]•quaque nocte (qn)[每晚1次]•quaque mane (qm)[每晨1次]•ante cibum(ac)[饭前（给药）]•post cibum (pc)[饭后（给药）]•hora somni (hs)[临睡时]•pro re nata (prn)[必要时]•si opus sit (sos)[必要时只用1次]•ante meridiem (am)[上午]•post meridiem (pm)[下午]•statim (st)[即刻](2)辅助检查术语[diagnostic examination]•CBC (complete blood count) [全血细胞计数]•WBC (white blood ount)[白细胞数]•RBC (red blood count) [红细胞数]•Ret (reticulocyte)[网织红细胞数]•HCT (hematocrit)[红细胞比积]•MCV (mean corpuscular volume) [红细胞平均体积] •MCH (mean corpuscular hemoglobin)[红细胞平均血红蛋白] •EC (eosinophic count)[嗜酸粒细胞计数]•Plt (platelet count)[血小板计数]•UA (urine analyse)[小便常规]•SRt (stool routine)[大便常规]•stool OB [大便隐血]•stool ova count[大便虫卵计数]•uric acid [尿酸]•uric (serum) amylase [尿（血）淀粉酶]•urine K+ (Na+)[尿钾（钠）测定]•pregnance test[妊娠试验]•urine Bence-Jone protein [尿本-周氏蛋白]•urinary protein electrophoresis[尿蛋白电冰]•bacterial count of urine [尿菌落数]•osmotic pressure assay[尿渗透压测定]•urine (blood, stool) culture [尿（血、大便）培养]•bone marrow puncture [骨穿]•iron staining of bone marrow smear [骨髓铁染色]•serum iron assay [血清铁测定]•Vit B12 and folic acid assay [维生素B12和叶酸测定]•BT (bleeding time) [出血时间]•CT (coagulation time) [凝血时间]•PT (prothrombin time)[凝血酶原时间]•ACT (activated coagulation time)[活化的凝血时间]•KPTT(kaolin partial thromboplastin time)[部分凝血活酶时间]•Fb (fibrinogen)[纤维蛋白原]•FDP (fibrinogen degradation product)[纤维蛋白原降解产物]•ABG (arterial blood gas)[血气分析]•renal function and liver function[肝肾功能]•D-dimer fragments assay[D-二聚体测定]•Hcy (homocysteine)[同型半胱氨酸]•Cr and BuN (creatinine and blood urea nitrogen)[肌酐和尿素氮]•blood lipid (TG, TC ,HDL, LDL)[血脂（甘油三酯，胆固醇，高密度脂蛋白，低密度脂蛋白）]•myocardial enzyme (CK, CK-MB, GOT, LDH)[心肌酶谱（肌酸磷酸激酶及同功酶，谷草转氨酶，乳酶脱氢酶）]•Mb (myoglobin)[肌红蛋白]•CTn-I [肌钙蛋白-I]•thyroid function (T3,T4,TSH,FT3 FT4,TG,TM)[甲状腺功能]•VMA (urine vanillylmandelic acid)[尿香草基杏仁酸]•LH, FSH, ACTH, GH[黄体生成素，卵泡刺激素，促肾上腺皮质激素，生长激素]•determination of calcitonin[降钙素测定]•17-KS and 17-OHCS[尿17-酮和17-羟测定]•plasma cortisol assay [皮质醇]•aldosterone assay[醛固酮]•testosterone and estradiol[睾酮和雌二醇]•FBS or blood glucose [空腹血糖或血糖]•SaO2 monitor [血氧饱和度监测]•CO2CP (carbon dioxide combining power)[二氧化碳结合力]•Uric ketobody[尿酮体]•serum electrolytes (K+,Na+,Ca2+,Cl-,Mg2+)[血电解质]•AFP(alpha-fetoprotein) [癌胚抗原]•β2-M(β2-microglobulin)[ β2微球蛋白]•Ccr (endogenous creatinine clearance)[内生肌酐清除率]•capillary resistance test [毛细血管脆性试验]•platelet adhesion and aggregation test[血小板粘附和凝集试验]•3P test (plasma protamine paracoagulation test)[血浆鱼精蛋白副凝试验] •plasma viscosity [血浆粘度]•whole-blood viscosity [全血粘度]•CSF (cerebrospinal fluid)[脑脊液]•semen (sputum, vaginal discharge) examination[精液（痰，阴道分泌物）检查]•total protein[总蛋白]•OGTT (oral glucose tolerance test)[口服糖耐量试验] •ASO (antistreptolysin O test)[抗“O”试验]•ANA (antinuclear antibody)[抗核抗体]•anti-ENA antibody [抗可提取性核蛋白（ENA）抗体] •anti-ds DNA[抗双链DNA抗体]•C3 (complement 3) [补体3]•CRP (C-reactive protein) [C-反应蛋白]•IC (immune complex)[免疫复合物]•RF (rheumatoid factor)[类风湿因子]•Widal`s reaction [肥达氏反应]•MIC (minimal inhibitory concentration)[最低抑菌浓度] •MBC (minimal bactericidal concentration)[最小杀菌浓度] •acid-fast stain[抗酸染色]•EKG [心电图]•bedside [床边]•chest (cervical) X-ray examination [胸部（颈部）X线检查] •P-A + lateral projection [正位+侧位]•echo (TTE, transthoracic echo)[经胸超声心动图]•echo (TEE, transesophageal echo)[经食道超声心动图] •Doppler echocardiography[多普勒超声心动图] •fluoroscopy [透视]医学全在线•CT (computerized-tomography)[计算机断层摄影]•MRI (magnetic resonance imaging)[核磁共振成像]•DSA (digital subtractive angiography)[数字减影血管造影术] •contrast enhancement[对比增强]•dacryocystography[泪囊造影]•Caldwell`s position [柯氏位]•Wayer`s position[瓦氏位]•Angiography [血管造影术]•coronary angiography [冠脉造影术]•right ventricul ography [右心造影术]•PTCA[经皮经腔冠脉成形术]•RFCA[经导管射频消融术]•stent[支架]•pacemaker implanted operation[起搏器植入术]•Holter (dynamic ECG)[24小时动态心电图]•ABPM[24小时动态血压监测]•treadmill test [平板运动试验]•bicycle ergometer[踏车试验]•tilt test[倾斜试验]•phonocardiog raphy[心音图]•atropine test[阿托品试验]•TEAP (transesophageal atrial pacing)[食道调搏]•EP study[电生理检查]•VCG (vectocardiogram)[心向量图]•EMG (electromyogram)[肌电图]•EEG (electroencephalogram)[脑电图]•barium enema[钡灌肠]•cholangiography[胆管造影术]•intravenous (oral) cholecystography[静脉（口服）胆囊造影] •pancratocholangiography[胰胆管造影]•selective heptatic arteriography[选择性肝动脉造影]•bronchography[支气管造影]•lung aspiration biopsy[肺针吸活检]•cystourethrography[膀胱尿道造影]•IVU (intravenous urography)[静脉尿道造影]•retrogradepyelography[逆行肾盂造影]•uterosalpingography[子宫输卵管造影]•CT-guided aspiration biopsy[CT 导向下穿刺活检]•cerebral angiography [脑血管造影]•vertebral angiography[椎动脉造影]•cisternography[脑室造影]•arterio (veno) graphy[动（静）脉造影]•lung functional examination[肺功能检查]•gastroscopy[胃镜检查]•endoscopy[內窥镜检查]•sigmoidoscopy[乙状结肠镜查]•colonoscopy[结肠镜检查]•colonofiberscopy[纤维结肠镜检查]•bronchoscopy[支气管镜检查]•ERCP (endoscopic retrograde cholangio-pancreatography)[经内镜逆行胰胆管造影] •catheterization[导尿术]医学全在线•thoracentesis[胸穿]•abdominocentesis（abdominal puncture）[腹穿]•pericardiocentesis[心包穿刺]•liver (renal) biopsy[肝（肾）活检]•bone marrow puncture[骨穿]•lumbar puncture[腰穿]•lymah node puncture [淋巴结穿刺]•joint cavity paracentesis [关节腔穿刺术]•examination of prostate[前列腺检查]•massage of prostate[前列腺按摩]•CVP measure [中心静脉压测定]•peripheral venous pressure measure [外周静脉压测定]•duodenal drainage[十二指肠引流]该文章转载自医学全在线：/yingyu/2008/20564_2.shtml。
知情同意管理制度
Management system of Informed consent 页数 1/51 知情同意包含下列两方面内容：Informed consent includes two aspects:1.1 知情：患者对病情、医疗措施、见习生、实习生和研究生参与的治疗范围、风险、备用治疗方案、费用开支、临床试验、治疗方案、治疗结果(包括意外情况)等真实情况的了解、被告知的权利。
Informed: the patient knows or is informed of such facts as present illness, medical measures, treatment scope of trainee,intern and postgraduate, risks, alternate treatment plan,medical expenses, clinical trial, treatment regimen and results(including unexpected conditions)1.2 同意：患者在知情的前提下有选择、接受或拒绝的权利。
Consent: having been informed, the patient has the right to select, accept or reject.2 知情同意的范围Scope of informed consent2.1 所有手术all operations；2.2. 有创检查和治疗，如胸穿、腰穿、骨穿、腹穿、深静脉置管、胃肠镜、支气管镜、血管造影、穿刺活检等Invasive examination and treatment, such as thoracentesis, lumbar puncture, bone marrow aspiration, peritoneocentesis, deepvein intubation, gastrointestinalscopy, bronchoscopy,angiography, puncture and biopsy；2.3 麻醉（局部麻醉除外） anesthesia (except local anesthesia)；2.4 使用特殊药物，如化疗、抗结核、大剂量免疫抑制治疗等Use special drugs, such as chemotherapy, tuberculostatic agents and large dose of immunosupressive agent；2.5 特殊治疗，如放疗等；special treatment, for example, radiotherapy2.6 输血及血液制品blood transfusion and blood products；Management system of Informed consent 页数 2/52.7 实践性医疗行为practical medical behavior；2.8 临床试验Clinical trial.3 知情同意内容Contents of informed consent3.1 采取诊疗措施的目的purpose of treatment measures；3.2 诊疗方法、具体操作流程及操作者Methods of diagnosis and treatment, operation process and operator3.3 预期的效果、副作用、风险及防范预案Expected effect, side effect, risks and prevention plan3.4 备选治疗方案alternate treatment plan3.5 相关费用等related expenses4 知情同意履行Carry out informed consent4.1 医务人员须以简明易懂的语言、图表或照片等方式告知患者或家属，并确认患者或家属是否已理解。
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Introduction
Multiple procedures (such as bone marrow aspiration and lumbar punctures) performed in children in pediatric oncology department. These procedures cause lots of pain for children and bring lots of stress for the patients and their families, particularly when these procedures are repeated many times during the diagnosis or treatment period (1). These procedures
Conclusion
General anesthesia by propofol and fentanyl may be a good choice for short-term painful procedures in children undergoing treatment for bone marrow aspiration/biopsy and intratechal injection.
Received: 27 November 2012 Accepted: 18 March 2013
Abstract Background
Multiple procedures (Lumbar puncture and bone marrow aspiration /biopsy) cause pain, stress, depression and etc for the patients and their families. Various methods have been recommended for pain reduction during invasive procedures. The aim of this study is to report the complications following general anesthesia.
signs of allergy, traumatic LP (bloody), and unusual local bleeding.
Results
In this study, 118 males and 84 females underwent 623 general anesthetic procedures with a median of 3 procedures per patient. Intraoperative period complications occurred in 48 of total 623 procedures (7.7 %). The most common complications were traumatic LP, bradycardia and decrease in arterial oxygen saturation which occurred in 25, 6 and 6 cases, respectively. Postoperative period complications occurred in 74 (11.9%) cases. The most common complications were vomiting, agitation and headache, decrease O2 saturation and bradycardia.
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Iranian Journal of Pediatric Hematology Oncology Vol3.No2
As children do not habituate to pain, general anesthesia is recommended for all bone marrow biopsies. General anesthesia or combination of analgesia and sedative drugs during painful procedures in pediatric oncology is recommended by The World Health Organization and the American Academy of Pediatrics (AAP). (8. 9, 10) Currently, various methods have been recommended for pain reduction during invasive procedures in this group of patients. These methods include: effective education for parents, preparation of the child for the procedure, cognitive behavioral therapy, sedation and general anesthesia (4). General anesthesia is defined as a drug-induced loss of consciousness when child is not arousal, even by painful stimulation. Children should be anesthetized by an anesthesiologist and in an operating room because some complications such as depressed ventilation, drug induced depression of neuromuscular function or cardiovascular dysfunction may occur and patient may need ventilation assistance (4). One of the common agents used for general anesthesia in children is propofol. This agent is administered intravenously and can induce rapid anesthesia when administered slowly over at least one minute. This agent causes a low incidence of nausea, vomiting and agitation during recovery. Another agent, fentanyl may be used in combination with propofol to alleviate pain, as propofol does not have analgesic properties. They also cause less adverse effects and shorter recovery time when used in combination (5, 6, and 7). As mentioned above, general anesthesia is recommended for all invasive procedures in pediatric patients with cancer. In this study, we will report the complications following general anesthesia for lumbar puncture and bone marrow aspiration /biopsy in children with cancer.
can also lead to depression and other psychiatric disorders (2). In a retrospective study of childhood cancer survivors, invasive procedures have been reported as the most difficult part of treatment, leading to posttraumatic stress symptoms in some long term survivors (3).
Materials and M来自thodsIn this prospective observational study, two hundred and two children with cancer were enrolled. All patients received propofol 2.5 mg /kg and fentanyl 1 µg/kg. After adequate anesthesia, procedures were performed by a pediatric oncologist. All anesthesia complications were classified into two groups: Intraoperative and Postoperative complications. Complications which were recorded include: abnormal age-specific bradycardia (≤20 × baseline), decrease in arterial oxygen satura≤t9io0n%),( laryngospasm, vomiting, agitation, headache, hypothermia (<35 C°), hyperthermia (>37/8 C°),