医学英语 慢性阻塞性肺疾病

• He had always been coughing with sputum during the past thirty years and tended to getting worse over recent five years, with breathlessness developing. • 病人近 30 年来一直有咳嗽、咳痰，近5年 来有所加重，伴气急。
• Chief Physician: When was the pulmonary function done? • 主任医师：肺功能是什么时候做的? • Intern (Dr. Grey): ( Looking through the chart ) Er... 6 months ago. • 实习医师：（翻看病历）嗯，6个月前。
医学英语
Bozhou People´s Hospital Rheumtology and immunology department 张玉慧
Bedside teaching
• Bedside teaching is seen as one of the most important modalities in teaching a variety of skills for the medical profession, which greatly improves certain clinical diagnostic skills in medical students and residents.
• Chief Physician: Good morning, Mr. Black. l'm Dr. Clark. I suppose you were all well until this outbreak, weren't you?
• 主任医师：早上好，Black 先生，我是 Clark 医生，我想你平时身体还不错吧？
Ward round
A. 早交班 morning meeting：住院总医师；外称 Senior Resident’s Morning Report B. 引言 introduction：主治医师；提出重点查房病例， 简述棘手问题 C. 病史报告 case presentation：实习医生，可有无诊 断，诊治计划须系统 D. 教学查房对话 teaching dialogue：在上下级医生之 间进行；着重纠错 E. 小结 summary：主治医师对主任查房作应答，提出 整改措施
• Chief Physician: Mr. Black, could we give you an examination? • 主任医师：Black 先生，可以给你做个体检吗? • Patient: Sure. • 病人：当然可以。 • Chief Physician: Now Dr. Grey, could you do the examination? • 主任医师：Grey 医生，你来做一下体检吧。 • Intern: Certainly. • 实习医生：好的。
• Patient: Not at all. In fact, I'm always coughing and wheezing in the past decades. But it's the first time I had to stay in hospital. You know, at the beginning, I was merely coughing, but it developed so fast that I couldn't stand it any more. ( Coughing ) • 病人：才不是呢！其实，我都喘了几十年了。 不过住院倒是头一回。要知道，一开始我也就 是咳嗽，但是后来发展得太严重了，我实在受 不了了！（咳嗽）
• Chief physician 主任医师 Resident 住院医师 • Attending physician 主治医师 Intern 实习医师 • Chief resident 住院总医师 Patient 病人
Chronic Obstructive Pulmonary Disease
• A previous pulmonary function examination showed that the forced expiratory volume in 1 second ( FEV1 ) was 1.5 liters and FEV1/forced vital capacity (FVC) was 50%. • 病人过去的肺功能检查示第1秒用力呼气量 （FEV1）是 1.5 L，第 1 秒用力呼气量/用力 肺活量（FEV1/FVC）是 50%.
• 病人：就是这个，有时候咳、喘得严重时， 医生会给我一些药或者静脉注射。
• Chief Physician: Have you felt better since admission? • 主任医师：住院以后好点了没有? • Patient: Yes. I feel much better this morning. • 病人：是的。今天早上我觉得好多了。
In the office
• Chief Resident: Your attention, please. The teaching ward round by Chief physician Professor Clark now begins. Firstly, let's have the case presented by Dr. Grey. • 住院总医师：请各位注意了，主任医师 Clark 教授的教学查房现在开始，首先由实 习医师 Grey 医生汇报病史。
• One week before admission, he caught a cold and suffered a relapse thereafter. Meanwhile, he had large volumes of purulent sputum and wheezed after moderate movement. He inhaled salbutamol as usual, but it didn't work this time. So he came. • 入院前 1 周，病人感冒后症状又有发作， 伴咯大量脓痰，动则气急。吸入沙丁胺醇 后症状无缓解。为求进一步诊治，入我院。
• Intern (Dr. Grey): This 70-year-old man was admitted because of a one-week history of breathlessness and cough with purulent sputum. • 实习医师：病人，男性，70 岁，因气急、 咳嗽、咳痰 1 周入院。
• COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. Progressive means the disease gets worse over time.
主治医师对主任查房作应答主治医师对主任查房作应答提出整改措施提出整改措施感谢下载chiefphysician主任医师attendingphysician主治医师chiefresident住院总医师resident住院医师intern实习医师patient病人感谢下载chronicobstructivepulmonarydiseasechronicobstructivepulmonarydiseaseprogressivediseasebreatheprogressivemeansdiseasegetsworseovertime
• Chief Physician: Anything else other than it? • 主任医师：除了这个还有其他的吗? • Patient: Mainly this, and sometimes the doctor gave me a few drugs or intravenous injections when I was badly coughing or wheezing.
• Chief Physician: Mr, Black, you arc smoking, aren't you? • 主任医师：Black 先生，你抽烟是吧? • Patient: Yes, l have been smoking for 50 years. • 病人：是的，我都抽了 50 年了。
• Almost every year he had to suffer for one to three months. He was continuously using salbutamol inhalation which did relieve the symptoms most of the time. • 几乎每年都有发作，持续1～3个月。病人 一直使用沙丁胺醇吸入治疗，症状多能缓 解。
• The symptoms were usually aggravated by cold weather or alternations of seasons, while tended to ease when the weather was getting warm.
• 症状通常于天气寒冷时或季节更替时发作， 天气回暖后好转。
• The patient has a smoking history of 100 pack years. And his family history was unremarkable. Mainly that's all. • 病人有吸烟史，100 包每年，家族史无特殊。 汇报完毕。
• Chief physician: Your presentation is quite clear. Were there any significant physical findings, Dr. Grey? • 主任医师：你的汇报很清楚。查体有什么 有意义的发现吗?
• Chief Physician: Don't worry, Mr. Black. What medication did you take before admission? • 主任医师：别担心，Black 先生。你这次住院 前有用什么药吗? • Patient: ( Taking out the bottle of salbutamol ) Here it is, but it did work anyway, except this time. • 病人：（拿出沙丁胺醇的瓶子）就是这个，挺 管用的，不过这次没用。
In the ward
• Chief Resident: Hello, Mr. Black. Our Chief Physician and the Attending Physician are coming to see you. • 住院总医师：你好，Black 先生，我们主任 医师和主治医师都来看你了。 • Patient: Good morning, doctors. • 病人：早上好，医生们。
• Chief Physician: Well, since we have learned about the history, it’s the very time to visit the patient.
• 主任医师：好，既然我们已经了解了病史，现在 该去看看病人了。 • Chief Resident: OK. Let’s go to the ward. • 住院总医师：好，那就去病房吧。
• 实习医师ห้องสมุดไป่ตู้我们仔细检查了病人，发现一 些肺部体征，包括桶状胸和肺部干啰音。 无口唇发绀和双下肢水肿。
• The laboratory tests reported that PaO₂ was 10 kPa and PaCO₂ was 5 kPa. However, WBC count was 9.9 X 10⁹/L, and the neutrophils were 90%. • 实验室检查报告：PaO₂ 10 kPa，PaCO₂ 5kPa； 白细胞计数 9.9×10⁹/L，中性粒细胞 90%。
• Intern (Dr. Grey): Yes. We examined the patient carefully and found signs of lung disease, including bucket-like-chest and bronchi. But there was no cyanosis in the lips and no edema of the legs.