醫(yī)學(xué)英語(yǔ)實(shí)用情景教程（高職）全套教學(xué)課件

醫(yī)學(xué)英語(yǔ)實(shí)用情景教程全套可編輯PPT課件全課導(dǎo)航Unit3GynecologyandObstetrics婦產(chǎn)科Unit2Surgery外科Unit4Pediatrics兒科Unit6Stomatology口腔科Unit5Ophthalmology眼科Unit7Otorhinolaryngology,HeadandNeckSurgery

耳鼻咽喉頭頸外科Unit9Neurology神經(jīng)科Unit8Dermatology皮膚科Unit10Emergency急診科Unit1InternalMedicine內(nèi)科Unit1InternalMedicine內(nèi)科知識(shí)目標(biāo)掌握內(nèi)科常見(jiàn)疾病的英文術(shù)語(yǔ)。掌握詢(xún)問(wèn)、描述內(nèi)科常見(jiàn)疾病的相關(guān)英文表達(dá)。掌握內(nèi)科英文病歷的寫(xiě)法。技能目標(biāo)能用英語(yǔ)與內(nèi)科患者溝通。能讀懂內(nèi)科相關(guān)的英文病歷。思政目標(biāo)能夠在未來(lái)工作中積極、主動(dòng)地發(fā)揮應(yīng)有的作用，利用自己的知識(shí)和技能，全身心地為國(guó)人健康服務(wù)。項(xiàng)目目標(biāo)1．學(xué)習(xí)“知識(shí)儲(chǔ)備”中的內(nèi)容，掌握本單元的重點(diǎn)醫(yī)學(xué)術(shù)語(yǔ)和常用表達(dá)。2．跟讀“醫(yī)患交流”下的英文對(duì)話(huà)，然后角色扮演各對(duì)話(huà)場(chǎng)景。3．仔細(xì)閱讀“病歷閱讀”下內(nèi)科相關(guān)的英文病歷，總結(jié)其中重點(diǎn)句型及詞匯。4．完成本單元的“任務(wù)檢測(cè)”。5．根據(jù)以上任務(wù)的完成情況，給自己評(píng)分。任務(wù)描述目錄123知識(shí)儲(chǔ)備醫(yī)患交流病歷閱讀章節(jié)導(dǎo)航01知識(shí)儲(chǔ)備CommonDiseasesofInternalMedicineKeyWordsandExpressionsModelSentencesCommonDiseasesofInternalMedicine心血管疾病arrhythmia /?'r?θm??/ 心律失常atrialfibrillation /'e?tr??l?fa?br?'le???n/ 心房顫動(dòng)ventricularfibrillation /ven?tr?kj?l??fa?br?'le???n/ 室顛heartarrest /hɑ?t?'rest/ 心臟驟停hypertension /?ha?p??ten?n/ 高血壓arteriosclerosis /ɑ??t??r???skl?'r??s?s/ 動(dòng)脈硬化myocardosis /?ma???kɑ?'d??s?s/ 心肌病pericarditis /?per?kɑ?'da?t?s/ 心包炎coronaryarteryheartdisease /'k?r?nr??ɑ?t?r?hɑ?td?'zi?z/ 冠心病CommonDiseasesofInternalMedicine腎臟內(nèi)科nephritis /ne'fra?t?s/ 腎炎renalfailure /'ri?nl'fe?lj?(r)/ 腎衰竭urinarytractinfection /'j??r?n?r?tr?kt?n'fek?n/ 尿路感染uremia /j?'ri?m??/ 尿毒癥pyelonephritis /?pa??l??n?'fra?t?s/ 腎盂腎炎CommonDiseasesofInternalMedicine內(nèi)分泌內(nèi)科hyperthyroidism /?ha?p?'θa?r??d?z?m/ 甲亢thyroiditis /?θa?r??'da?t?s/ 甲狀腺炎diabetes /?da??'bi?ti?z/ 糖尿病CommonDiseasesofInternalMedicine呼吸內(nèi)科cold /k??ld/ 感冒pneumonia /nju?'m??n??/ 肺炎asthma /'?sm?/ 哮喘respiratoryfailure /r?'sp?r?tr?'fe?lj?(r)/ 呼吸衰竭respiratorydistresssyndrome /r?'sp?r?tr?d?'stres's?ndr??m/呼吸窘迫綜合征CommonDiseasesofInternalMedicine消化內(nèi)科gastritis /g?'stra?t?s/ 胃炎gastriculcer /?g?str?k??ls?/ 胃潰瘍duodenalulcer /?dju???di?nl??ls?/ 十二指腸潰瘍diarrhea /?da??'r??/ 腹瀉hepatitis /?hep?'ta?t?s/ 肝炎enteritis /?ent?'ra?t?s/ 小腸炎pancreatitis /?p?nkr??'ta?t?s/ 胰腺炎colitis /k?'la?t?s/ 結(jié)腸炎gastrointestinalbleeding /?g?str???n'test?nl'bli?d??/ 胃腸道出血CommonDiseasesofInternalMedicine血液內(nèi)科anemia /?'ni?mi??/ 貧血leukemia /lu?'ki?m??/ 白血病lymphoma /l?m'f??m?/ 淋巴瘤CommonDiseasesofInternalMedicine風(fēng)濕免疫內(nèi)科gout /ga?t/ 痛風(fēng)01020304rheumatoidarthritis/'ru?m?t??dɑ?'θra?t?s/類(lèi)風(fēng)濕性關(guān)節(jié)炎o(hù)steoarthritis/??st???ɑ?'θra?t?s/ 骨關(guān)節(jié)炎ankylosingspondylitis/??k?'l??z???sp?nd?'la?t?s/強(qiáng)直性脊柱炎KeyWords

andExpressionsaspirin /'?spr?n/

n. 阿司匹林offandon 斷斷續(xù)續(xù)stiff /st?f/

adj. 僵硬的rash /r??/

n. 皮疹migraine /'mi?gre?n/ n. 偏頭痛depression /d?'pre?n/ n. 抑郁；沮喪pulse /p?ls/ n. 脈搏sufferfrom （因疾病等）受折磨KeyWords

andExpressionsdizzyspells /'d?z?spelz/ 陣發(fā)性頭暈swollen /?sw??l?n/ adj. 腫脹的ankle /???kl/ n. 腳踝shortofbreath 呼吸困難orso 大約pregnancy /?pregn?ns?/ n. 懷孕fatal /?fe?tl/ adj. 致命的stroke /str??k/ n. 中風(fēng)chronicillness 慢性疾病、KeyWords

andExpressionsinstruction /?n?str?k?n/ n. 指示；吩咐irondeficiencyanemia 缺鐵性貧血indigestion /??nd?'d?est??n/ n. 消化不良acupuncture /'?kj?p??kt??(r)/ n. 針刺療法havenoobjection 無(wú)異議injection /?n?d?ek?n/ 注射distension /d?'sten?n/ n. 脹numbness /?n?mn?s/ n. 麻ModelSentences1.Dotheycomeatanyspecialtimeoftheday?頭痛在一天中有特定發(fā)作時(shí)間嗎？2.Doesithelptotakeaspirinortoliedown?吃阿司匹林或躺下能減輕疼痛嗎？3.I’vehadheadachesoffandonforthelastseveralyears,butnoneasbadasthis.最近幾年來(lái)我斷斷續(xù)續(xù)地有過(guò)頭痛，但是都沒(méi)有像這次這么厲害。4.Doyouhavemigraines?你是否有偏頭痛？5.Doyoufeelacertaindegreeofupsetordepression?你感到有某種程度的心煩或壓抑嗎？ModelSentences6.Ineedtotakeyourtemperature,pulseandbloodpressure.我需要量一下你的體溫、脈搏和血壓。7.YouneedtohaveabloodtestandtakeanX-rayofyourheadandneck.你需要去做一個(gè)血液檢查，頭部及脖子做一個(gè)X光檢查。8.Youshouldhaveagoodrest,avoidnervoustensionorstress,andgiveupsmokingandavoidalcohol.你應(yīng)該好好休息，避免精神緊張或壓力過(guò)大，戒煙酒。9.I’vebeensufferingfromdizzyspellsandaterribleheadachelately.最近我總是感到一陣陣眩暈，頭也疼得厲害。ModelSentences10.Doyoufeelshortofbreathwhenyouclimbstepsordoheavywork?你上樓梯或干重活時(shí)是否感到呼吸短促？11.Itis170over100.That’salittlehigh.你的血壓是170/100，有點(diǎn)高。12.Leftuntreated,hypertensioncanleadtostrokes,heartattack,kidneydamageanddeath.如果不治療，高血壓可以導(dǎo)致中風(fēng)、心臟病、腎臟損害和死亡。13.Youlookverypale.你看起來(lái)很蒼白。14.Anyothercomplaints?Howisyourappetite?還有其他不舒服的嗎？食欲怎樣？ModelSentences15.SometimesmylegsaresoweakthatIcan’tevenclimbthestairs.Occasionally,Ifeelshortofbreathandgiddy.有時(shí)我的兩條腿特別無(wú)力，我甚至不能爬樓梯。有時(shí)候我覺(jué)得氣短和頭暈。16.Accordingtothebloodtest,youaresufferingfromanirondeficiencyanemia.血液檢查表明你得的是缺鐵性貧血。17.Lieonthecouchagainandrelax.Justtakeiteasy.躺在床上，放松，請(qǐng)不要緊張。18.Isthereasenseofdistensionandnumbness?有脹和麻的感覺(jué)嗎？19.Ihavesomethingwrongwithmystomach,anditissopainfulthatIcanhardlysleepovernight.我的胃很不舒服，幾乎痛得我整夜都睡不著覺(jué)。ModelSentences20.I’vegotacoldformorethanoneweek,andIthinkImighthaveapulmonaryinfectionbecauseIhavebeencoughingthesedays.我已經(jīng)感冒將近一周，我感覺(jué)自己可能感染了肺炎，因?yàn)檫@些天我一直在咳嗽。21.Ihadarunningnoseafewdaysago,andfromyesterdayIbegantohaveasorethroat,IamafraidIhavegotaterriblecold.我前幾天開(kāi)始鼻塞，從昨天開(kāi)始喉嚨疼，我覺(jué)得我可能得了重感冒。22.I’vegotasplittingheadache.MoreoftenthannotitgetsworseeverymorningwhenIgetup.Ifeelasifeverythingisspinningaroundme.我最近總是頭痛，每天早上起床的時(shí)候癥狀會(huì)更明顯，感覺(jué)周?chē)磺卸荚谛D(zhuǎn)。ModelSentences23.Doesanybodyinyourfamily,suchasyourparentsorsiblings,havethisdisease?你家人有患過(guò)你這種疾病的嗎？比如你的父母和姐妹。26.Ihadthiskindofpainwhichisoffandontwoyearsago.Itseemstoberelatedtomydailyeatinghabits.兩年前我間斷有過(guò)類(lèi)似這樣的癥狀，可能跟我的日常飲食有關(guān)系。24.Couldyoutellmewhatelseyou’venoticedwhenthepaincomes?痛的時(shí)候，你還有沒(méi)有注意到其他伴隨的癥狀？25.Haveyoueverbeentootherhospitals?Andhaveyoueverdoneanykindofexaminationlikethis?Hasanykindofdiagnosisbeenmadeeverbefore?之前有去過(guò)其他醫(yī)院做過(guò)類(lèi)似的檢查嗎？過(guò)往有得出過(guò)診斷結(jié)果嗎？課堂小結(jié)這小結(jié)我們學(xué)習(xí)了內(nèi)科醫(yī)學(xué)中的常見(jiàn)病、關(guān)鍵詞和表達(dá)式和模型句子。希望大家課下多加復(fù)習(xí)，加深對(duì)英語(yǔ)詞匯的理解。02醫(yī)患交流Conversation1Headache頭痛Conversation2Hypertension高血壓Conversation3Anemia貧血Conversation4Stomachache胃痛Conversation1Headache頭痛D:What’sthematter,Mr.Wang?P:Isufferfromterribleheadaches.D:Whendidtheybegin?P:Aboutaweekago.D:Whereisthepain?Inwhichpartofyourhead?P:Allovertheforehead.D:Dotheycomeatanyspecialtimeoftheday?P:No.TheyseemtocomeatanytimeIgetnervous.D:Doesithelptotakeaspirinortoliedown?P:No.Theyjustseemtogoawaybythemselves.醫(yī)生：你怎么了，王先生？患者：我頭痛得厲害。醫(yī)生：什么時(shí)候開(kāi)始的？患者：大約一個(gè)星期前。醫(yī)生：哪兒痛？在你頭的什么部位？患者：整個(gè)前額部都痛。醫(yī)生：頭痛在一天中有特定發(fā)作時(shí)間嗎？患者：沒(méi)有。似乎是在我精神緊張時(shí)才頭痛。醫(yī)生：吃阿司匹林或躺下能減輕疼痛嗎？患者：不能減輕。不過(guò)頭痛好像可以自行消失。D:Haveyoueverhadthiskindofheadachebefore?P:Well,I’vehadheadachesoffandonforthelastseveralyears,butnoneasbadasthis.D:Doyouhaveastiffneck?P:Yes.D:Canyouturnandbowyourhead?P:Yes.D:Canyourchesttouchyourchin?P:Yes.D:Doesbrightlightmakeyoureyesacheandyourheadacheworse?P:Yes,Ican’tstandstronglight.醫(yī)生：你以前有過(guò)這種頭痛嗎？患者：哦，最近幾年來(lái)我斷斷續(xù)續(xù)地有過(guò)頭痛，但是都沒(méi)有像這次這么厲害。醫(yī)生：你感覺(jué)脖子僵硬嗎？患者：是的。醫(yī)生：能轉(zhuǎn)頭和低頭嗎？患者：可以。醫(yī)生：你能用下巴碰到你的胸部嗎？患者：可以。醫(yī)生：明亮的光線會(huì)刺痛眼睛，使頭痛加劇嗎？患者：是的，我不能忍受強(qiáng)光。Conversation1Headache頭痛D:Doyouhaveanyrashesonyourarms,legsorbody?P:No,Ididn’tseeany.D:Doyouhaveafever?P:Idon’tthinkso.D:Hasyourheadbeenhitrecently?P:No.D:Doyouhaveanyothersymptomswhentheheadachecomes?P:Yes,Ioftenfeelsick.SometimesIactuallyvomit.D:Doyouhavemigraines?P:Notoften.D:Doyoufeelacertaindegreeofupsetordepression?P:Idon’tthinkso.醫(yī)生：你的手臂、腿部和身體有沒(méi)有皮疹？

患者：沒(méi)有，我沒(méi)有看到。醫(yī)生：你發(fā)燒了嗎？患者：我覺(jué)得沒(méi)有。醫(yī)生：頭部最近受過(guò)撞擊嗎？患者：沒(méi)有。醫(yī)生：你頭痛時(shí)還有別的癥狀嗎？

患者：有，我經(jīng)常感到惡心，有時(shí)還會(huì)吐。

醫(yī)生：你是否有偏頭痛？患者：不是經(jīng)常有。醫(yī)生：你感到有某種程度的心煩或壓抑嗎？

患者：我認(rèn)為沒(méi)有。Conversation1Headache頭痛D:Doyoudrink?P:Yes.D:Well,Ineedtotakeyourtemperature,pulseandbloodpressure.(aftertheexamination)

YouneedtohaveabloodtestandtakeanX-rayofyourheadandneck.Thenursewilltakeyouthereandyouneedtocomebackwiththeresults.P:OK,thankyou.(aftertheexamination)D:Youshouldhaveagoodrest,avoidnervoustensionorstress,andgiveupsmokingandavoidalcohol.Inaddition,I’llgiveyousomemedicine.P:OK,thankyou.Bye-bye!D:Bye-bye!醫(yī)生：你喝酒嗎？患者：喝。醫(yī)生：好的。我需要量一下你的體溫、脈搏和血壓。（檢查完后）你需要去做一個(gè)血液檢查，頭部及脖子做一個(gè)X光檢查。護(hù)士會(huì)帶你過(guò)去，做完了帶著檢查結(jié)果回來(lái)找我?；颊撸汉玫模x謝。（檢查完后）醫(yī)生：你應(yīng)該好好休息，避免精神緊張或壓力過(guò)大，戒煙酒。此外，我會(huì)給你開(kāi)些藥?；颊撸汉玫模x謝。再見(jiàn)!醫(yī)生：再見(jiàn)！Conversation1Headache頭痛P:Goodmorning,doctor.D:Goodmorning,sitdown,please.Howdoyoufeelrecently?P:I’vebeensufferingfromdizzyspellsandaterribleheadachelately.D:Whereisthepain?Andhowlongdoesitlast?P:Justhere.ItseemstocomeatanytimewhenIgetnervous.D:Haveyoueverhadthiskindofheadachebefore?P:Onlyoccasionally.Anditseemstogoawaybyitself.D:Doyouthinkyourvisionisgettingworse?P:Onlyalittle.患者：早上好，醫(yī)生。醫(yī)生：早上好，請(qǐng)坐，近來(lái)感覺(jué)怎么樣啊？患者：最近我總是感到一陣陣眩暈，頭也疼得厲害。醫(yī)生：哪里痛？頭痛持續(xù)多長(zhǎng)時(shí)間了？患者：就是這里，似乎我一緊張頭就痛。醫(yī)生：以前有過(guò)類(lèi)似的頭痛嗎？患者：偶爾有點(diǎn)。而且疼痛好像是自然緩解的。醫(yī)生：你的視力變差了嗎？患者：有一點(diǎn)點(diǎn)。Conversation2Hypertension

高血壓D:Haveyoueverhadswollenankles?P:No,Ihaven’tnoticedthat.D:Haveyougotheartdiseaseorakidneyproblem?P:Notyet.D:Doyoufeelshortofbreathwhenyouclimbstepsordoheavywork?P:Yes,often.Abouteverytenstepsorso,Ihavetostopandcatchmybreath.D:Well,letmeexamineyourbloodpressure.P:Whatisit?D:Itis170over100.That’salittlehigh.P:DoesitmeanIhavehypertension?D:Yes.P:Oh,that’sawful.Whatcauseshypertension?醫(yī)生：你的腳踝腫過(guò)嗎？患者：我以前沒(méi)注意過(guò)。醫(yī)生：你患過(guò)心臟病或腎病嗎？患者：沒(méi)有。醫(yī)生：你上樓梯或干重活時(shí)是否感到呼吸短促？患者：嗯，經(jīng)常。每上十級(jí)左右的臺(tái)階，我就得停下來(lái)喘口氣。醫(yī)生：嗯，來(lái)讓我給你量一下血壓。患者：血壓是多少？醫(yī)生：你的血壓是170/100mmHg，有點(diǎn)高?；颊撸耗且馕吨一加懈哐獕?？醫(yī)生：是的?；颊撸赫嬖愀?。高血壓的病因是什么？Conversation2Hypertension

高血壓D:Thereisnospecificcause,butsomefactorsthatcancausehighbloodpressurearekidneyproblems,pregnancyortakingdrugs.P:Iwonderwhetheritisafataldisease.D:Leftuntreated,hypertensioncanleadtostrokes,heartattack,kidneydamageandevendeath.P:Itsoundsterrible.D:Actually,hypertensionisthemostcommonchronicillness.Becausepatientscanbesymptom-free,manypeoplethinkhighbloodpressureisharmless.P:WhatshallIdo?D:Youneedtoquitsmokingandalcohol,loseweightanddosomeexercises.P:Anythingelse?醫(yī)生：沒(méi)有特定的原因，但是某些因素能引起高血壓，比如腎臟疾病、懷孕或服用藥物?；颊撸翰恢栏哐獕菏遣皇侵旅募膊?。醫(yī)生：如果不治療，高血壓可以導(dǎo)致中風(fēng)、心臟病、腎臟損害，甚至死亡?；颊撸郝?tīng)起來(lái)太可怕了。醫(yī)生：實(shí)際上高血壓是一種常見(jiàn)的慢性病。因?yàn)榛颊邲](méi)有任何癥狀，許多人認(rèn)為高血壓對(duì)身體無(wú)礙?；颊撸何以撛趺崔k呢？醫(yī)生：你應(yīng)該戒煙酒，減輕體重，做些運(yùn)動(dòng)。患者：還有什么？Conversation2Hypertension

高血壓D:Justhavealow-saltdietwithalotofvegetablesandsomefruits,andalimitedamountofmeat.Also,youshouldhaveagoodrest,avoidnervoustensionorstress.P:DoIneedtotakemedicine?D:Yes.Youneedtotakemedicinetoloweryourbloodpressure.P:Isthereanyspecialinstruction?D:Youshouldtakethemedicineasdirectedanddonotstopunlessyouaretoldtobythedoctor.P:Thanksalot.醫(yī)生：保持低鹽飲食，多吃蔬菜、水果，少吃肉。你還應(yīng)該好好休息，避免緊張或壓力過(guò)大。患者：我需要服藥嗎？醫(yī)生：是的。你需要服藥來(lái)降低血壓。患者：有沒(méi)有特別的醫(yī)囑？醫(yī)生：你應(yīng)按照規(guī)定服藥，除非醫(yī)生同意，不能擅自停藥?；颊撸悍浅８兄x！Conversation2Hypertension

高血壓P:Ihavefeltweakrecently.Ihavefeltworseforthelastfewdays.D:Youlookverypale.Howlonghaveyoubeenlikethis?P:I’mnotquitesure.I’vebeenfeelingtiredforayearorso.D:Anyothercomplaints?Howisyourappetite?P:Myappetiteisallright.Ijustfeeltired.SometimesmylegsaresoweakthatIcan’tevenclimbthestairs.Occasionally,Ifeelshortofbreathandgiddy.D:IwantyoutohaveabloodtestnowandI’llwaitfortheresult.(aftertheexamination)Accordingtothebloodtest,youaresufferingfromanirondeficiencyanemia.P:WhatshouldIdo？D:Iamgoingtoprescribeyousomeirontablets,whichshouldbetakenaftermealsortheywillspoilyourappetite.患者：我最近覺(jué)得乏力。這幾天更重。

醫(yī)生：你看起來(lái)很蒼白。你病了多久了？

患者：我不能肯定。我感到疲乏已經(jīng)有一年左右了。醫(yī)生：還有其他不舒服的嗎？你的食欲怎么樣？患者：我的食欲還好。我只是感到疲勞。有時(shí)我的兩條腿特別無(wú)力，甚至不能爬樓梯。有時(shí)候我覺(jué)得氣短和頭暈。

醫(yī)生：我希望你做一次血液檢查，我在這里等結(jié)果。（檢查完后）血液檢查表明你得的是缺鐵性貧血。

患者：我該怎么辦呢？醫(yī)生：我給你開(kāi)一些鐵片，在飯后服用，否則會(huì)影響你的食欲。Conversation3Anemia貧血D:What’syourtrouble,Mr.Smith?P:I’vehadapaininmystomachsincethismorning.D:Wheredoesithurt?P:Here.D:Lieonthecouchandletmeexamineyou.Doyoufeelanypainhere?P:No.D:Whatabouthere?P:Yes,that’stheplace.D:That’sall.Youcangetoffthecouchnow.Itisindigestion.I’dliketouseacupunctureonyouifyouhavenoobjection.P:No,I’veheardalotabouttheeffectivenessofacupunctureandI’dliketotryit.醫(yī)生：你哪里不舒服，史密斯先生？患者：我從早晨起來(lái)就開(kāi)始胃痛。醫(yī)生：哪里痛？患者：這兒。醫(yī)生：請(qǐng)?zhí)傻皆\察臺(tái)上，讓我檢查一下。這里痛嗎？患者：不痛。醫(yī)生：這兒呢？患者：對(duì)，就是這個(gè)位置。醫(yī)生：行，你現(xiàn)在可以下來(lái)了。是消化不良。如果你沒(méi)有異議的話(huà)，我想用針刺治療法?；颊撸汉玫模衣?tīng)聞針刺治療的療效很好，我想試試看。Conversation4Stomachache胃痛D:Inyourcase,asingleneedleshouldbeenoughtorelievethepain.Look,thisistheneedle.P:Howfarwillitgo?P:Howfarwillitgo?D:Aboutaninch.Butdon’tbenervous.Ifyoucanstandaninjection,youcanstandthisneedle.P:Allright.Goahead.D:Lieonthecouchagainandrelax.Justtakeiteasy.Doesithurt?P:Justalittle.醫(yī)生：像你這種情況，一針就能緩解病痛。看，這是針?；颊撸横樢M(jìn)多深？患者：針要進(jìn)多深？醫(yī)生：約2.54厘米，但請(qǐng)不要緊張，如果你能受得了注射，就能受得了針刺治療?；颊撸汉玫?，來(lái)吧。醫(yī)生：躺在床上，仰臥放松，請(qǐng)不要緊張，痛嗎？患者：有一點(diǎn)兒。Conversation4Stomachache胃痛D:(twistingtheneedle)Now,isthereasenseofdistensionandnumbness?P:Yes.D:That’sgood.Justresthereforawhile.I’llbebackinabouttwentyminutes.(twentyminuteslater)

Howdoyoufeelnow?P:Muchbetter.D:Justholdstillforasecond.I’lltaketheneedleout.P:Ifeelfinenow.It’sreallymarvelouswhatthatlittleneedlecando!Thankyouverymuch,doctor.D:Gladtohavehelpedyou.醫(yī)生：（捻轉(zhuǎn)針）有脹和麻的感覺(jué)嗎？

患者：有。

醫(yī)生：好的，你在這兒休息一會(huì)兒。我將在約20分鐘后回來(lái)。（20分鐘后） 你現(xiàn)在感覺(jué)如何？患者：好多了。醫(yī)生：再堅(jiān)持一會(huì)兒，我把針取出來(lái)?；颊撸何椰F(xiàn)在感覺(jué)很好。這根小針真了不起！非常感謝你，醫(yī)生。醫(yī)生：能幫到你我感到很高興。Conversation4Stomachache胃痛課堂小結(jié)這小結(jié)我們學(xué)習(xí)了如何用英語(yǔ)進(jìn)行醫(yī)患交流。希望大家課下多加復(fù)習(xí)，加深對(duì)英語(yǔ)的靈活應(yīng)用。03病歷閱讀OutpatientMedicalRecords—CerebralInfarctionInpatientMedicalRecords—HypertensionOperationRecords—RadiofrequencyAblationforPersistentAtrialFibrillationUnder3-DMappingPhysicalExamination—HypertensionOutpatientMedicalRecords—CerebralInfarctionChiefComplaint:Alaliaanddysphagiaformorethan2months.HistoryofPresentIllness:Thepatientpresentedwithalaliaanddysphagiawithoutobviouspredisposingcauses2monthsago.Thepatientwasdiagnosedas“stroke”in××Hospital.Withoutanyimprovementofthecondition,thepatientwasadmittedtoourdepartmentas“cerebralinfarction”forfurthertreatment.Afterhewasill,hismentalstate,strength,appetiteandsleepwerepoor.Hisurinationanddefecationwerenormal.Hisbodyweighthadnosignificantchanges.PastMedicalHistory:Thepatienthasbeensufferedfromhypertensionfor5yearsandthesituationofthebloodpressurecontrolisunknown.Nohistoryofdiabetesmellitus,butahistoryoflong-termanemia.Nohistoryofsurgeriesandtrauma.Nohistoryofbloodtransfusion.Nohistoryofmedicineandfoodallergybefore.OutpatientMedicalRecords—CerebralInfarctionPhysicalExamination:Temperature:36.9℃ Pulse:65bpmRespiratoryRate:20bpm BloodPressure:152/81mmHgThepatient,whohadaclearmindandactiveposition,waswelldevelopedandmoderatelynourished.Thehead,eyes,ears,noseandoropharynxwerenormal.Theneckwassoft.Thetracheawasinmidline.Therewasnothyroidenlargement.Therewasnojugularveindistention.Thecarotidartery’spulsationwasnormal.Thethoraciccagewasnormal,andtherewerenovaricoseveinsonthethoracicwall.Thepercussionsoundedclear.Thebreathsoundwasnormal.Theabdomenwasflat,andtherewasnoabdominalmusculartension,novaricoseveinsontheabdominalwall,nomasses,notenderness,noreboundtenderness.AuxiliaryExamination:NonePrimaryDiagnosis:cerebralinfarctionTreatment:drugtherapy,regularexamination.Doctor’sSignature:Zhang××門(mén)診病歷—腦梗死主訴：言語(yǔ)不清伴吞咽困難2月余?，F(xiàn)病史：患者2月前無(wú)明顯誘因出現(xiàn)言語(yǔ)不清伴飲食嗆咳等不適，于××醫(yī)院就診后，診斷為“中風(fēng)”。今患者感言語(yǔ)不清及吞咽困難無(wú)明顯好轉(zhuǎn)，為求進(jìn)一步治療，來(lái)我院就診?；疾∫詠?lái)，患者精神、體力欠佳，食欲、睡眠差，大、小便無(wú)異常，體重?zé)o明顯變化。既往史：既往有“高血壓”5年，血壓控制情況不詳；無(wú)“糖尿病”病史，有長(zhǎng)期“貧血”病史，無(wú)手術(shù)史，無(wú)外傷史，無(wú)輸血史，無(wú)藥物、食物過(guò)敏史。OutpatientMedicalRecords—CerebralInfarction門(mén)診病歷—腦梗死體格檢查：體溫：36.9℃脈搏：65次/分呼吸：20次/分血壓：152/81mmHg發(fā)育正常，營(yíng)養(yǎng)中等，意識(shí)清楚，自動(dòng)體位。頭顱正常，眼正常，耳正常，鼻正常，口咽正常。頸項(xiàng)軟，氣管居中，甲狀腺不腫大，頸靜脈無(wú)怒張，頸動(dòng)脈搏動(dòng)正常。胸廓正常，無(wú)胸壁靜脈曲張，叩診呈清音，呼吸音正常。腹部外形平坦，腹肌軟，無(wú)腹壁靜脈曲張，腹部無(wú)腫塊，無(wú)壓痛、反跳痛。輔助檢查：暫無(wú)初步診斷：腦梗死處理：藥物治療，按時(shí)檢查。醫(yī)師簽名：張××OutpatientMedicalRecords—CerebralInfarctionName:Wang×× Gender:MaleAge:53yearsold Race:HanOccupation:Other MaritalStatus:MarriedNationality:China NativePlace:××PresentAddress:×××× RepresentorofMedicalHistory:PatientDateofAdmission:1stJun.,2019 DateofRecord:15:58,1stJun.,2019ChiefComplaint:Hypertensionformorethan10years,poorbloodpressurecontrolfor1year.HistoryofPresentIllness:Thepatient’sbloodpressurewasnotwellcontrolledoneyearago,whichfluctuatedbetween130—170/80—110mmHg.Hehadnodizziness,headache,palpitation,chesttightness,coldsweating,nauseaandvomiting.Hevisitedourhospitalforfurtherdiagnosisandtreatmentandwasadmittedtoourdepartmentfromtheclinicduetohypertension.Sincetheonsetofillness,thepatienthadordinaryspiritandphysicalstrength,hadapoorappetite,normalsleep,normalurinationwithoutraisinginthenight,normaldefecation,andnosignificantchangeinbodyweight.InpatientMedicalRecords—HypertensionPastMedicalHistory:Thepatienthadnomedicalhistoryofdiabetes,nohistoryofhepatitisorotherinfectiousdiseases,nohistoryofoperation,injuryorbloodtransfusion,nohistoryofdrugorfoodallergy,andthevaccinesweregivenaccordingtothelocalregulations.PersonalHistory:Thepatientwasbornandgrewupinthenativeplaceandhadnohistoryoflivinginotherplacesforalongtime.Thepatienthasahighschooldegree.Thepatienthadnohistoryoflivingintheepidemicarea,nohistoryofexposuretoepidemicwaterorepidemicfocus,nohistoryofexposuretoradioactivesubstancesortoxicsubstances,aswellasnohistoryofdrugabuseandlong-termhistoryofdruguse.MarriageandChild-bearingHistory:Thepatientismarriedandthepatient’sspouseandchildrenareingoodhealth.FamilyHistory:Thepatient’sparentswerehealthy.Thepatient’schildrenwereingoodhealth.Thereisnohistoryofinfectiousdiseasesandhereditarydiseasesinhis/herfamily.Thereisnofamilyhistoryofearlycardiovasculardiseases.Doctor’sSignature:Gan××InpatientMedicalRecords—Hypertension入院病歷（病史采集）—高血壓姓名：王××

性別：男年齡：53歲

民族：漢職業(yè)：其他

婚姻狀況：已婚國(guó)籍：中國(guó) 籍貫：××現(xiàn)住址：×××× 病史陳述者：本人入院日期：2019-06-01 病歷記錄時(shí)間：2019-06-01，15:58主訴：高血壓發(fā)現(xiàn)10余年，控制欠佳1年?，F(xiàn)病史：患者于1年前血壓控制欠佳，血壓波動(dòng)于130～170/80～110mmHg，無(wú)頭暈、頭痛，無(wú)心悸、胸悶、出冷汗，無(wú)惡心嘔吐，為求進(jìn)一步診治，來(lái)我院就診，門(mén)診遂擬“高血壓病”收入我科。患者自患病以來(lái)，精神狀態(tài)一般，體力情況一般，食欲不振，睡眠情況一般，小便正常，無(wú)夜尿增多，大便正常，體重?zé)o明顯變化。InpatientMedicalRecords—Hypertension入院病歷（病史采集）—高血壓既往史：無(wú)糖尿病病史，無(wú)肝炎等傳染病史，無(wú)手術(shù)史，無(wú)外傷史，無(wú)輸血史，無(wú)藥物、食物過(guò)敏史，預(yù)防接種隨當(dāng)?shù)剡M(jìn)行。個(gè)人史：生于原籍，在原籍長(zhǎng)大，無(wú)長(zhǎng)期外地居住史，高中文化。無(wú)疫區(qū)居住史，無(wú)疫水、疫源接觸史，無(wú)放射物、毒物接觸史，無(wú)毒品接觸史，無(wú)長(zhǎng)期服藥史。婚育史：已婚，配偶及子女健康狀況良好。家族史：父母均體健，子女健康狀況良好，家族中無(wú)傳染病及遺傳病史。無(wú)早發(fā)心血管病家族史。醫(yī)師簽名：甘××InpatientMedicalRecords—HypertensionOperationRecords—RadiofrequencyAblationforPersistentAtrialFibrillationUnder3-DMappingName:Zhang××DateofSurgery:11thMay,2019PreoperativeDiagnosis:PersistentatrialfibrillationIntraoperativeDiagnosis:PersistentatrialfibrillationNameofOperation:Cardiacelectrophysiology+radiofrequencyablationforpersistentatrialfibrillationunder3-DmappingSurgeon:ProfessorZhang××AnesthesiaMethod:IntravenousanesthesiaProcedureofOperation:Thepatienttookasupineposition.Routinedisinfectionanddrapingwereperformed.Intravenousanesthesiawasperformed.Puncturesoftherightjugularveinandrightfemoralveinwereperformed.Circumferentialpulmonaryveinelectricalisolationwasperformedundertheguidanceof3-Dmapping.OperationRecords—RadiofrequencyAblationforPersistentAtrialFibrillationUnder3-DMappingAfterbilateralcircumferentialpulmonaryveinelectricalisolation,linearablationforapexandbaseofatriumandendocardiumofthecoronarysinuswasperformed.Therhythmoftheatriumwasregular.After200Jsynchronizedelectricalcardioversion,thesymptomwasconvertedtoatrialflutter.Electrophysiologicalexaminationshowedbidirectionalobstructionofeachablationray.Consideringthatablationwaseffective,thetubeandsheathwereremoved,andpressuredressingwasperformedfortheincision.Thepatient’svitalsignsinandafteroperationwerestable,withoutspecialdiscomfort.Thepatientwassentbacktothewardsafely.Surgeon’sSignature:Zhang××SignaturebySuperiorDoctor:Wang××手術(shù)記錄—三維標(biāo)測(cè)下持續(xù)性房顫射頻消融術(shù)姓名：張××手術(shù)日期：2019-05-11術(shù)前診斷：持續(xù)性心房顫動(dòng)術(shù)中診斷：持續(xù)性心房顫動(dòng)手術(shù)名稱(chēng)：心內(nèi)電生理檢查+三維標(biāo)測(cè)下持續(xù)性房顫射頻消融術(shù)手術(shù)醫(yī)師：張××教授麻醉方式：靜脈麻醉OperationRecords—RadiofrequencyAblationforPersistentAtrialFibrillationUnder3-DMapping手術(shù)記錄—三維標(biāo)測(cè)下持續(xù)性房顫射頻消融術(shù)手術(shù)經(jīng)過(guò)：患者取仰臥位，常規(guī)消毒鋪巾，靜脈麻醉，穿刺右頸內(nèi)靜脈、右股靜脈。在三維圖指導(dǎo)下行環(huán)肺靜脈電隔離術(shù)。雙側(cè)肺靜脈電隔離成功后，行心房頂部、底部及冠狀竇心內(nèi)膜面線性消融，患者心房律變規(guī)則，予以200J同步電復(fù)律后患者轉(zhuǎn)為房撲。行電生理檢查，證實(shí)各消融線雙向阻滯，考慮消融成功，遂拔管拔鞘傷口加壓包扎。術(shù)中、術(shù)后患者生命體征平穩(wěn)，未訴特殊不適，安返病房。手術(shù)醫(yī)師簽名：張××上級(jí)醫(yī)師簽名：王××OperationRecords—RadiofrequencyAblationforPersistentAtrialFibrillationUnder3-DMappingTemperature:36.2℃ Pulse:70bpm RespiratoryRate:20bpmBloodPressure:170/118mmHg BodyWeight:75kg Height:170cmBodyMassIndex:25.9kg/m2Thepatienthadnormaldevelopment,moderatenutrition,normalappearance,activeposition,sanity,normalgaitsandwascooperativewhilebeingexamined.Therewasnoyellow-stainingofskinandsclera.Theskullshowednormalsizewithoutmalformationormass,andthefivesenseorganswerewell-featured.Thepalpebralconjunctivashowednoedema.Thebilateralpupilswereroundandequalinsizewiththediameterofabout3mmandwithsensitivelightreflex.Therewasnomalformationofauriculae,noexudationofexternalauditorycanals,noflaringofnaresandnosecretainthenasalcavities.Thebuccalmucosawasruddyandtheoralmucosashowednoulcerorbleeding,thepharynxshowednocongestionandthebilateraltonsilswerenotenlarged.PhysicalExamination—HypertensionTheneckwassoftwithoutdistentionofjugularvein.Theheartratewas70beats/minwithregularrhythmandnormalcardiacsound,nosplittingofheartsoundsorextracardiacsound.Therewerenocardiacmurmursorpericardialfrictionrubs.Thepulsewavewasnormal.Theabdomenwasflatwithoutabdominalwallvaricosis.Theliverandspleenwerenottouchedunderribs.Nomasswaspalpatedintheabdomen.Therewasnoshiftingdullness,andtheborborygmuswasnormal.Theanusandgenitaliawerenotexamined.Thespineandlimbsshowednomalformation,bothlowerlimbsshowednoedemaandthepulseofdorsalarteriesofthefootwasnormal.ThephysiologicalreflexwassensitiveandtheKernig’ssign,Brudzinski’ssignandBabinski’ssignwerenotelicited.PhysicalExamination—Hypertension體格檢查—高血壓體溫：36.2℃ 脈搏：70次/分

呼吸：20次/分

血壓：170/118mmHg體重：75kg 身高：170cm 體重指數(shù)：25.9kg/m2發(fā)育正常，營(yíng)養(yǎng)中等，正常面容，自動(dòng)體位，神志清楚，檢查合作，正常步態(tài)。全身皮膚、鞏膜無(wú)黃染，頭顱大小正常，無(wú)畸形及腫塊，五官端正，瞼結(jié)膜無(wú)水腫，雙側(cè)瞳孔等大、等圓，直徑約3mm，對(duì)光反射靈敏，耳郭無(wú)畸形，外耳道無(wú)溢液，鼻翼無(wú)煽動(dòng)，鼻腔無(wú)分泌物，唇黏膜紅潤(rùn)，口腔黏膜無(wú)潰瘍及出血，咽部無(wú)充血，雙側(cè)扁桃體不大。頸軟，頸靜脈無(wú)怒張。心率70次/分，律齊，心音正常，無(wú)心音分裂，無(wú)額外心音，未聞及心臟雜音及心包摩擦音。正常脈波。腹部平坦，無(wú)胃腸型及蠕動(dòng)波，肝、脾肋下未觸及，腹部未觸及包塊，移動(dòng)性濁音陰性，腸鳴音正常。肛門(mén)及外生殖器未查。脊柱及四肢無(wú)畸形，雙下肢無(wú)水腫，雙側(cè)足背動(dòng)脈正常。生理反射靈敏，未引出克氏、布氏、巴氏征。PhysicalExamination—Hypertension思想引領(lǐng)讓醫(yī)學(xué)始終飽含美麗與溫度“一個(gè)真正的好醫(yī)生，不僅要有科學(xué)的腦、靈巧的手，更要有仁愛(ài)的心?！眹?guó)家衛(wèi)生健康委員會(huì)副主任在2020年中國(guó)醫(yī)學(xué)人文大會(huì)上表示，在醫(yī)學(xué)活動(dòng)中，醫(yī)患彼此休戚與共，解決醫(yī)患關(guān)系緊張的切入點(diǎn)就是大力弘揚(yáng)醫(yī)學(xué)人文精神。醫(yī)務(wù)人員首先要堅(jiān)持以患者為中心，不斷提高人文素養(yǎng)，把維護(hù)人民群眾健康作為自己的職業(yè)責(zé)任和使命，始于心誠(chéng)，而成于精湛。國(guó)務(wù)院辦公廳印發(fā)的《關(guān)于加快醫(yī)學(xué)教育創(chuàng)新發(fā)展的指導(dǎo)意見(jiàn)》中提出，要以“大國(guó)計(jì)、大民生、大學(xué)科、大專(zhuān)業(yè)”的新定位推進(jìn)醫(yī)學(xué)教育改革創(chuàng)新發(fā)展，在優(yōu)化醫(yī)學(xué)學(xué)科專(zhuān)業(yè)結(jié)構(gòu)，推進(jìn)醫(yī)學(xué)與多學(xué)科深度交叉融合，提升醫(yī)學(xué)人才培養(yǎng)質(zhì)量和醫(yī)學(xué)科研創(chuàng)新能力等方面做出全面部署。其中，將醫(yī)德醫(yī)風(fēng)相關(guān)課程作為必修課程，培養(yǎng)仁心仁術(shù)的醫(yī)學(xué)人才的新表述備受關(guān)注。思想引領(lǐng)這一指導(dǎo)意見(jiàn)針對(duì)性強(qiáng)，不僅強(qiáng)調(diào)了醫(yī)務(wù)人員對(duì)患者的人文關(guān)懷，也體現(xiàn)了黨和政府對(duì)醫(yī)務(wù)人員的人文關(guān)懷，必將為我國(guó)醫(yī)師隊(duì)伍建設(shè)的高質(zhì)量發(fā)展注入強(qiáng)勁動(dòng)力。目前全球抗疫形勢(shì)依然嚴(yán)峻，我國(guó)面對(duì)長(zhǎng)期常態(tài)化防控的挑戰(zhàn)和壓力，同時(shí)健康中國(guó)建設(shè)正在全面深入推進(jìn)，在新的形勢(shì)下，我們要繼續(xù)弘揚(yáng)飽含人文情懷的抗疫精神，從源頭培養(yǎng)更多具有人文情懷、堪當(dāng)大任的人民健康守護(hù)者。中國(guó)醫(yī)師協(xié)會(huì)齊學(xué)進(jìn)顧問(wèn)講話(huà)指出，在醫(yī)學(xué)科技迅猛發(fā)展的今天，永遠(yuǎn)高舉醫(yī)學(xué)人文的旗幟，讓醫(yī)學(xué)始終飽含美麗與溫度，是我們這個(gè)行業(yè)和每一位醫(yī)師的首要職責(zé)和使命。課堂小結(jié)這小結(jié)我們學(xué)習(xí)了如何用英語(yǔ)進(jìn)行病歷閱讀。希望大家課下多加復(fù)習(xí)，加深對(duì)英語(yǔ)的靈活應(yīng)用。任務(wù)檢測(cè)場(chǎng)景模擬1．請(qǐng)以小組（2人）為單位根據(jù)以下情景進(jìn)行英語(yǔ)會(huì)話(huà)。李××，男，55歲，平時(shí)喜歡喝酒、吃肉，有一天半夜突然感到腳趾關(guān)節(jié)痛，腳趾表面又紅、又熱、又腫，無(wú)法入睡。第二天到醫(yī)院進(jìn)行就診，預(yù)約掛號(hào)后，李醫(yī)生對(duì)他的病情進(jìn)行了詢(xún)問(wèn)，并得出了可能的病情結(jié)論。2．請(qǐng)根據(jù)自己的醫(yī)學(xué)知識(shí)或?qū)嵙?xí)經(jīng)驗(yàn)，選擇一個(gè)或兩個(gè)除“醫(yī)患交流”外的內(nèi)科常見(jiàn)疾病進(jìn)行英語(yǔ)會(huì)話(huà)。任務(wù)檢測(cè)病歷翻譯ChiefComplaint:Chesttightnessandshortnessofbreathfor10days.HistoryofPresentIllness:Thepatientpresentedwithchesttightnessandpalpitationaftertheinfectionoftheupperrespiratorytract10daysago,whichwouldbeworseafterphysicalactivity.Thepatienthadnofever,chestpain,coughandsputumandvisited××hospital.TheECGshowedventricularprematurebeats.Withoutanyeffectivenessbytakingcompounddanshentabletsorally,thepatientcametoourhospitalforfurthertreatment.PastMedicalHistory:Thepatientsufferedfromhypertensionforyears,takingmedicationirregularly.Thepatienthasa10-yearsmokinghistory.Nohistoryoffamilydiseasesorhereditarydiseases.PhysicalExamination:Thepatienthadageneralstate.Thebloodpressurewas150/90mmHg.Thestrengthofapicalimpulsewasmoderate.Theheartratewasarrhythmicat70bpm.Theprematurebeatscouldbeaudibleatabout10bpm.Thebreathsoundswerenormalofbothlungs.任務(wù)檢測(cè)Theabdomenwasflatandsoftandhadnotenderness.Theneurologicsystemshowednoabnormalitiesduringthecheck.AuxiliaryExamination:ECGshowedfrequentventricularprematurebeats.NoobviousabnormitiesinchestX-ray.Themyocardialenzymewasnormal.PrimaryDiagnosis:1.frequentventricularprematurebeats2.viralmyocarditis?3.coronaryarteryheartdisease?4.hypertension(Ⅰ,highrisk)Treatment:1.MexiletineHydrochlorideTablets,50mg,p.o.,t.i.d.2.Wenxinparticle,10g,peros,b.i.d.3.Morerest,avoidexcitement,preventfromgettingcold.4.Follow-up.Doctor’sSignature:Zhang××任務(wù)評(píng)價(jià)可參考表進(jìn)行任務(wù)評(píng)價(jià)?？己藘?nèi)容評(píng)分等級(jí)評(píng)分標(biāo)準(zhǔn)自評(píng)分教師評(píng)分專(zhuān)業(yè)名詞掌握情況及格0<掌握數(shù)量<50%

良好50%≤掌握數(shù)量<70%優(yōu)秀70%≤掌握數(shù)量<85%卓越掌握數(shù)量≥85%內(nèi)科“醫(yī)患交流”掌握情況及格跟讀三遍“醫(yī)患交流”部分的對(duì)話(huà)

良好跟讀三遍“醫(yī)患交流”部分的對(duì)話(huà)，并與小組成員脫稿完成兩組對(duì)話(huà)的