浙江省住院医师规范化培训英语翻译.doc

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1、临床医学英语Chapter1Patient-PhysicianInteractionPage1第一章医患沟通第１页Thepatient-physicianinteractionproceedsthroughmanyphasesofclinicalreasoninganddecisionmaking.proceed进行、开展reasoning推论、推理clinicalreasoning诊断clinicaldecision确定治疗方案makingdecision做出决定医患沟通在临床诊断和治疗决策的许多阶段中进行着。Theinteractionbeginswithanelucidationofc

2、omplaintsorconcerns,followedbyinquiriesorevaluationtoaddresstheseconcernsinincreasinglypreciseways.elucidation说明、阐明inquire询问、调查evaluation评估、评价这种沟通开始于病人诉说或所关注问题，然后通过询问、评估不断精确地确定这些问题。Theprocesscommonlyrequiresacarefulhistoryorphysicalexamination,orderingofdiagnostictests,integrationofclinicalfindings

3、withthetestresults,understandingoftherisksandbenefitsofthepossiblecoursesofaction,andcarefulconsultationwiththepatientandfamilytodevelopfutureplans.integration综合consultation磋商、会诊这个过程通常需要细致的病史询问和体格检查，进行诊断性化验，综合临床发现和化验结果，理解分析拟行治疗过程中的风险和疗效，并与病人及家属反复磋商以形成治疗方案Physiciansincreasinglycancallonagrowingliter

4、atureofevidence-basedmedicinetoguidetheprocesssothatbenefitismaximized,　whilerespectingindividualvariationsamongdifferentpatientsrespecting注意到、关系、说到evidence-basedmedicine循证医学医生们越来越容易查阅不断增长的循证医学文献来指导这个过程，使得疗效最大化，但要考虑到不同病人中个体差异是存在的。Theincreasingavailabilityofrandomizedtrialstoguidetheapproachtodiagno

5、sisandtherapyshouldnotbeequatedwith“cookbook”medicineavailability　可利用性，可得到randomize随机的cookbook食谱，烹调书approach接近越来越多的可用于指导临床诊断与治疗的随机试验资料不应变成“烹调书”医学。Evidenceandtheguidelinesthatarederivedfromitemphasizeprovenapproachesforpatientswithspecificcharacteristics.Evidence证据，迹象guideline　指导方针emphasize强调因为随机试验获

6、得的现象和思路是着重于特征性病人的求证过程。Substantialclinicaljudgmentisrequiredtodeterminewhethertheevidenceandguidelinesapplytoindividualpatientsandtorecognizetheoccasional.substantialclinical真实的，实在的individual个体occasional偶尔的，特殊的41实际的临床判断需要确定这些现象和思路能否应用于某个病人个体，并能找出例外。Evenmorejudgmentisrequiredinthemanysituationsinwhic

7、hevidenceisabsentorinconclusive.inconclusive不确定性，非决定性许多情况下，临床表现缺乏或不典型，需要考虑更多的判断。Evidencealsomustbetemperedbypatients’preferences,althoughitisaphysician’sresponsibilitytoemphasizewhenpresentingalternativeopt