病例閱讀課件

醫(yī)學漢語MedicalChineseContents內容Vocabulary詞匯1Casereading病例閱讀2Situationaldialogue情景會話3CompanyLogo

DigestiveSystemabsorptionaminoacidsamylaseanusappendixbilebilirubinbowel吸收氨基酸淀粉酶肛門闌尾膽汁膽紅素腸canineteethcecumcoloncommonbileductdefecationdentindigestionduodenum犬齒盲腸結腸膽總管排便牙本質消化十二指腸CompanyLogo

DigestiveSystemelimination

emulsificationenamelenzymeesophagusfattyacidsfecesgallbladder排泄乳化琺瑯質酶食道脂肪酸糞便膽囊glucoseglycogenhydrochloricacidileumincisorinsulinjejunumlipase葡萄糖糖原鹽酸回腸切牙，門牙胰島素空腸脂肪酶CompanyLogo

DigestiveSystemlivermasticationmolarteethpalatepancreaspapillaeparotidglandperistalsis肝臟咀嚼磨牙，臼齒顎胰腺舌乳頭腮腺蠕動pharynxportalveinproteasepulppyloricsphincterrectumrugaesaliva咽門靜脈蛋白酶牙髓幽門括約肌直腸胃褶皺唾液CompanyLogo

DigestiveSystemsalivaryglandssigmoidcolonsphincterstomachtriglyceridesuvulavilli唾液腺乙狀結腸括約肌胃甘油三酯懸雍垂，小舌腸絨毛CompanyLogo

DigestiveSystemanorexiaascitesborborygmusconstipationdiarrheadysphagiaeructationflatus厭食腹水腸鳴音便秘腹瀉吞咽困難打嗝，噯氣胃腸氣，屁hematocheziajaundicemelenanauseasteatorrhea便血黃疸黑便惡心，反胃脂肪瀉SymptomsCompanyLogo

DigestiveSystemaphthousstomatitisdentalcariesherpeticstomatitisoralleukoplakiaperiodontaldiseaseachalasiaesophagealvaricesgastriccarcinoma口瘡性口炎齲齒皰疹性口炎口腔白斑牙周病食道失弛癥食管靜脈曲張胃癌herniapepticulceranalfistulacolonicpolyposiscolorectalcancerCrohndiseasediverticulosisdysentery疝胃潰瘍肛瘺結腸息肉直腸結腸癌克羅恩病憩室病痢疾PathologicalConditionsCompanyLogo

DigestiveSystemhemorrhoidsileusintussusceptionulcerativecolitisvolvuluscholelithiasiscirrhosispancreatitis痔瘡腸梗阻腸套疊潰瘍性結腸炎腸扭轉膽結石肝硬化胰腺炎viralhepatitis病毒性肝炎PathologicalConditionsCompanyLogo

DigestiveSystemliverfunctiontestsstoolculturehemocculttestbariumenemacholangiographyabdominalultrasonographymagneticresonanceimagingliverscan肝功能檢查gangongnengjiancha大便培養(yǎng)dabianpeiyang大便隱血試驗dabianyinxueshiyan鋇灌腸beiguanchang膽管造影danguanzaoying腹部超聲fubuchaosheng磁共振cigongzhen肝掃描gansaomiaoLaboratoryTests,ClinicalProceduresCompanyLogo

DigestiveSystemgastricbypassgastrointestinalendoscopyliverbiopsynasogastricintubationparacentesisCTscan胃旁路術weipanglushu胃腸內窺鏡檢查weichangneikuijing肝活組織檢查ganzhuzhihuojian經(jīng)鼻胃管插入術jingbiweiguancharu穿刺術chuancishu計算機斷層掃描jisuanjiduancengsaomiaoLaboratoryTests,ClinicalProceduresCompanyLogo

DigestiveSystemGastricUlcerwithBleeding-melena,hematemesis患者，男性，45歲，因“黑便3次，嘔血1次”于2004年1月28日入院。Huanzhe,nanxing,sishiwusui,yin“heibiansanci,ouxueyici”yuerlinglingsinianyiyueershibariruyuan.CasereadingⅠ胃潰瘍伴出血---黑便、嘔血Weikuiyangbanchuxue—heibian、ouxueA45-year-oldmanpresentedonJan.28,2004totheemergencydepartmentwithmelenaforthreetimesandvomitingofbloodforonetime.CompanyLogo

DigestiveSystem患者三天前飲酒后出現(xiàn)中上腹不適，解黑便一次，量約200g，當時不伴乏力，頭暈，冷汗，心慌，患者未予重視。Huanzhesantianqianyinjiuhouchuxianzhongshangfubushi,jieheibianyici,liangyue200ke,dangshibubanfali,touyun,lenghan,xinhuang,huanzheweiyuzhongshi.CasereadingⅠThreedaysbefore,afterdrinkingsomealcohol,thepatientdevelopedmelenaofabout200gbutwithoutfatigue,dizziness,coldsweatorrapidheart-beat,sohedidn’tpaymuchattention.CompanyLogo

DigestiveSystem2天前嘔吐咖啡色胃內容物1次，量約200ml，解柏油樣便2次，約200g，同時伴有乏力，冷汗，心慌，急送我院急診。Liangtianqianoutukafeiseweineirongwuyici,liangyue200haosheng,jiebaiyouyangbianliangci,yue200ke,tongshibanyoufali,lenghan,xinhuang,jisongwoyuanjizhen.CasereadingⅠTwodaysbefore,hesuddenlyvomitedcoffee-likefluidofabout200ml,followedbymelenatwice,withthetotalamountofabout200g.Hefeltfatigue,coldsweatandpalpitationandwassenttotheemergencydepartmentimmediately.CompanyLogo

DigestiveSystem測血壓60/30mmHg,糞便隱血試驗（++++）。既往無肝炎病史，無腎衰史，無急性應激史，未服非甾體類消炎鎮(zhèn)痛藥。吸煙史20年，每天一包。無飲酒史，有一姐姐死于胃癌。Cexueyaliushidaosanshihaomigongzhu,fenbianyinxueshiyansigejia.Jiwangwuganyanbingshi,wushenshuaishi,wujixingyingjishi,weifufeizaitileixiaoyanzhentongyao.Xiyanshi20nian,meitianyibao.Wuyinjiushi,youyijiejiesiyuweiai.CasereadingⅠHisbloodpressurewas60/30mmHgandthestooloccultbloodtestwas(++++).Hehadnohistoryofhepatitis,

renalfailure,acutestressorhistoryofNSAIDadministration.Hehad20-yearhistoryofsmokingonepackofcigarettesperday,anddenieduseofalcohol.Oneofhissistersdiedofgastriccarcinoma.CompanyLogo

DigestiveSystem入院體檢：體溫37.5oC,血壓60/30mmHg,呼吸19次/分，心率102次/分。神志清晰，鞏膜無黃染，貧血貌，未見肝掌，蜘蛛痣，淺表淋巴結未及腫大。Ruyuantijie:tiwei37.5sheshidu,xueya…h(huán)aomigongzhu,Xinlv102cimeifen.Shenzhiqingxi,gongmowuhuangran,pinxuemao,weijianganzhang,zhizhuzhi,qianbiaolinbajieweijizhongda.CasereadingⅠPhysicalexamination:T:37.5oC,BP:60/30mmHg,R:19/min,HR:102bpm.Conscious,nojaundiceofsclera,paleappearance,noliverpalm,nospiderangiomaonthechest,nopalpationofsuperficiallymphnodes.CompanyLogo

DigestiveSystem雙肺聽診無異常。腹軟，無壓痛反跳痛，未及腫塊，肝脾肋下未及。無移動性濁音，腸鳴音亢進。肛指陰性，下肢無水腫，神經(jīng)系統(tǒng)體征（-）。Shuangfeitingzhenwuyichang;furuan,wuyatongfantiaotong,weijizhongkuai,ganpileixiaweiji.Wuyidongxingzhuoyin,changmingyinkangjin.Gangzhiyinxing,xiazhiwushuizhong,shenjingxitongtizhengyinxing.CasereadingⅠBilaterallungauscultationnegative;abdomensoft,notendernessorreboundtenderness,nomasspalpated,liverandspleenarenotpalpatedbelowtheribcage,shiftingdullness(-),bowelsoundsactive,analdigitalexamination(-),noedemaoflowerlimbs,nervoussystem(-).CompanyLogo

DigestiveSystemLivercirrhosisandascites--fatigue,anorexia,abdominalswellingandoliguria患者，男，57歲，因“乏力、納差2個月，腹脹、少尿半月”于2003年1月20日入院。Huanzhe,nan,wushiqisui,yin“fali,nachalianggeyue,fuzhang,shaoniaobanyue”yu2003nian1yue20riruyuan.CasereadingⅡ肝硬化腹水---乏力、納差、腹脹、少尿Ganyinghuafushui—fali,nacha,fuzhang,shaoniaoA57-year-oldfemalepatientwasadmittedonJan.20th,2003becauseof“fatigueandanorexiafor2months,abdominalswellingandoliguriaforhalfamonth”.CompanyLogo

DigestiveSystem患者2月前無明顯誘因下出現(xiàn)乏力，體力下降，由原來每餐2兩降至1兩,且伴有低熱，自服感冒藥后略有好轉。Huanzheliangyueqianwumingxianyouyinxiachuxianfali,tilixiajiang,youmeicanerliangjiangzhiyiliang,qiebanyoudire,zifuganmaoyaohoulueyouhaozhuang.CasereadingⅡTwomonthsbefore,thepatientbegantofeelfatigue,decreasedtoleranceofphysicalactivitiesandanorexiawithoutanyidentifiablecauses.Sheusedtoeat100griceeverymeal,butnowshecouldonlyeat50g.Shealsohadlow-gradefeverandfeltbetteraftertakinganti-coldmedications.

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DigestiveSystem半月前，患者出現(xiàn)腹脹，褲子腰圍漸緊，尿量也漸減少，每日尿量約500ml，尿色黃。Banyueqian,huanzhechuxianfuzhang,kuziyaoweijianjin,niaoliangyejianjianshao,meiriniaoliangyue500haosheng,niaosehuang.CasereadingⅡHalfamonthbefore,thepatientbegantofeelabdominalswelling.Herpants’waistbeltbecametightforher.Urinevolumedecreasedto500mleverydayandthecolorwasdark.CompanyLogo

DigestiveSystem患者遂就診于當?shù)蒯t(yī)院，行腹部B超檢查，示肝硬化、脾腫大、大量腹水?；颊?0年前曾患過急性乙型肝炎，以后的幾年中肝功能反復有異常。Huanzhesuijiuzhenyudangdiyiyuan,xingfububichaojiancha,shiganyinghua,pizhongda,daliangfushui.Huanzhe20nianqiancenghuanguojixingyixingganyan,yihoudejinianzhonggangongnengfanfuyouyichang.CasereadingⅡThenthepatientwenttothedistricthospitalnearbyandtooktheabdominalultrasoundexamination.Theresultshowedshehadlivercirrhosis,splenomegaly,andlargevolumeofascites.ThepatienthadhepatitisB20yearsago.Duringtheyearsaftertheacuteinfection,herliverfunctionwasabnormalintermittently.CompanyLogo

DigestiveSystem患者無煙酒嗜好，已婚，育有一子、一女，女兒及丈夫身體健康，其子曾患乙肝。父親死于肝癌，母親仍健在。Huanzhewuyinjiushihao,yihun,yuyouyizi,yinv,nverjizhangfushentijiankang,qizicenghuanyigan.Fuqinsiyuganai,muqinrengjianzai.CasereadingⅡShehadnohabitofsmokingandalcohol.Shewasmarriedandhadonesonandonedaughter.Herdaughterandhusbandwerebothhealthy.HersonhadhepatitisBinfection.Herfatherdiedofprimaryhepaticcancer.Hermotherisstillalive.CompanyLogo

DigestiveSystem入院體檢：體溫37.5oC,血壓120/80mmHg,呼吸18次/分，心率100次/分。神清,慢性肝病面容，鞏膜輕度黃染，肝掌（+），左頸部可見蜘蛛痣，淺表淋巴結未觸及腫大。Ruyuantijian:tiwen37.5sheshidu,xueya..haomigongzhu,huxi18cimeifen,xinlv100cimeifen.Shenqing,manxingganbingmianrong,gongmoqingduhuangran,ganzhang,zuojingbukejianzhizhuzhi,qianbiaolinbajieweichujizhongda.CasereadingⅡPhysicalexamination:T:37.5oC,BP:120/80mmHg,R:18/min,HR:100bpm.Conscious,hepaticface,mildjaundiceofsclera,liverpalm(+),spiderangiomaonleftneck,nopalpationofsuperficiallymphnodes.CompanyLogo

DigestiveSystem雙肺呼吸音清，心界正常大小。腹部明顯膨隆，未見腹壁靜脈曲張，腹軟，腹部無明顯壓痛，移動性雜音（+）。腸鳴音正常。雙下肢中度水腫，神經(jīng)系統(tǒng)體征（-）。Shuangfeihuxiyinqing,xinjiezhengchangdaxiao.Fubumingxianpenglong,weijianfubujingmaiquzhang,furuan,fubuwumianxianyatong,yidongxingzayinyigejia.Changmingyinzhengchang.Shuangxiazhizhongdushuizhong,shenjingxitongtizhengyinxing.CasereadingⅡLungauscultationnegative,heart(-).Abdominalfindings:obviousabdominalbulge(markedprotuberanceoftheabdomen),nodistentionofabdominalwallveins,soft,nopain,shiftingdullness(+),normalactiveintestinalsound,moderateedemaoflowerlimbs,NS(-).CompanyLogo

DigestiveSystem實習生：15床，現(xiàn)在您哪兒不舒服？Shixisheng:shiwuchuang,xianzaininnaerbushufu病人：我肚子痛。Bingren:woduzitong.DialogueⅠIntern:BedNo.15,whichpartofyourbodyisnotfeelingwellnow?Patient:Myabdomenisaching.CompanyLogo

DigestiveSystem實：是上腹部嗎？Shishangfubuma?。簩Αui實：痛了多長時間了？Tongleduochangshijianle病：從前天晚上十點開始一直在痛congqiantianwanshangShidiankaishiyizhizaitong.DialogueⅠIntern:Isitattheepigastrium?Patient:Yes.Intern:Howlonghasitbeenlikethis?Patient:Itbeganfrom10PmthedaybeforeyesterdayCompanyLogo

DigestiveSystem實：您指指看，是哪兒痛？Nizhizhikan,shinaertong病：開始時是上腹部痛，后來是右側腹部劇痛，就是這兒。Kaishishishishangfubutong,houlaishiyoucefubujvtong,jiushizheer.DialogueⅠI:Canyouindicatetheachingplacebypointatit?P:Thepainstartsattheepigastrium,andthenIfeelthesharppainattherightabdomen-here.CompanyLogo

DigestiveSystem實：您感覺是什么樣的痛？Ninganjieshishenmeyangdetong病：持續(xù)地痛，越來越痛，像刀割一樣。坐著痛，躺著也痛，痛死我了。Chixvditong,yuelaiyuetong,xiangdaogeyiyang,tangzheyetong,tongsiwole.DialogueⅠI:Whatkindofpainisit?P:It’sacontinuouspain.Anditbecomessharper,likebeingcutbyaknife.It’sallthesamewhetherI’msittinguporlyingdown.Oh,it’skillingme!CompanyLogo

DigestiveSystem實：其他地方也跟著痛嗎？Qitadifangyegenzhetongma?。罕巢坑覀纫哺?，腰的右側也不舒服。Beibuyouceyegenzhetong,yaodeyouceyebushufu.DialogueⅠI:Isanyotherpartofthebodyalsoaffected?P:Myrightbackaches,too.Andtherightlumbarregionfeelsuncomfortable.CompanyLogo

DigestiveSystem實：劇痛之后發(fā)冷嗎？有沒有發(fā)燒？Jutongzhihoufalengma?Youmeiyoufashao?。簺]發(fā)冷，但有點低燒。Meifaleng,danyoudiandishao.實：小便是什么顏色？Xiaobianshishenmeyanse??。荷铧S色。Shenguangse.DialogueⅠI:Doyoufeelachillafterthesharppain?Doyouhavefever?P:Nochill,butIhavealowfever.I:Whatcolorisyoururine?P:Darkyellow.CompanyLogo

DigestiveSystem實：您還記得前天晚上吃什么了嗎？Nihaijideqiantianwanshangchishenmelema病：記得。前天晚上，我們單位有個宴會，我吃了很多牛排、雞肉和煎蛋?；丶液缶透杏X不舒服，惡心，還吐了。DialogueⅠI:Doyourememberwhatyouhadeatenthenightbefore?P:Yes.Thatnight,Iatealotofbeefsteak,chickenandfriedeggsatourunit’sdinnerparty.Ifeltuncomfortableandsickaftergettinghome,andIeventhrewup.CompanyLogo

DigestiveSystem實：一共吐了幾次？Yigongtulejici?病：四五次吧。Siwuciba.實：吐的是什么東西？有沒有血或綠色的東西？Tudeshishenmedongxi?Youmeiyouxuehuolvsededongxi?。和碌闹饕呛鹊暮统缘臇|西，沒有血和綠色的東西。Tudezhuyaoshihedehechidedongxi,meiyouxuehelvsededongxiDialogue