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1、医学口语会话】:晕厥 patient : Doctor I have been suffering from fits for a few years . I wonder what matter is with me and hope youll help me get rid of them soon. Doctor : What do you mean by a fit? P: By fit I mean I lose consciousness and fall on the ground on sudden . D: P: What time did your attack begi
2、n? When I was married and only 25 years old . D: How many years so far? P: Over three years . D: How long does each attack last? P: About a minute. D: attacks? Sometimes round a month , and sometimes two months . How long is the interval between two successive P: Could it be related to circumstances
3、? D: What lind of cases usually provokes your attacks? P: It is difficult to say exactly . Once when I was crossing the street, a swiftly moving car suddenly drove by and I became very hervous , I couldnt control myself. I screamed and blacked out . D: Were you injured? P: No , the car stopped at on
4、ce . I came to quickly then walked home . D: Any other attacks? P: On another occasion , no sooner had a nurse drawn blood from a patient than I felt perspiration and weakness followed by loss of consciousness. D: Did you have other manifestations during the attack? P: I was told by eyewitmesses tha
5、t I became pale and sweated excessively during the attack, but I had no convulsions , incontinence or anything else. D: Have you had any special examinations? P: The doctors working in our countys hospital told me that my physical examination, electr ocardiogram , and chest and skull x-ray examinati
6、on results were normal . Ive had no other special examinations. D: Let me give you a thorough physical and neurological examinaltion . Some furtherexaminations should be done including an electroencephalogram and a brain scan . Also the electrocardiogram should be repeated . Here are your referral s
7、heets . After you have had all these examinations please come back for another checkup. P: I have had all the examinations you ordered. Are all the results back yet? D: Yes , and all the results are normal. P: Then what is the cause of my fits? D: The normal results of physical and neurological exam
8、inations and other special examinations suggest neither organic heart or brain diseases nor epilepsy . The symptoms and signs which occus during an attack, such as palpitations , paleness and excessive sweating coincide with an imbalance of the autonomic nervous system function . Dysfunction of the
9、autonomic nervous system can lead to a decrease in the cardiac output, cerebral anemia , suppression of brain function , and finally to a loss of consciousness . Such an attack is termed syncope. P: Can you give me some medicine to calm the syncope down? D: Yes . You should pay more attention to reg
10、ulating your life such as getting up and going to bed regularly and not drinking or smoking too much . Ill give you some medicine to regulate the function of your autonomic nervous system . If you follow my advice, Im sure your condition will get better soon. Sometimes your symptoms may recur this i
11、s a natural phenomenon . Dont worry, such recurrences dont mean regression . During the struggle against disase , you must feel confident that you can overcome it , then the medicine , which Ill give you will help you defeat the enemy-syncope . Medicine is one way confidence is another . The latter
12、is more important than the former . You must keep my words in your mind . P: Thanks a lot, doctor. 病人:医生,近几年来我常常 突然发作. 我真想知道我得了什 么病,希望您快些给治好。 医生:您说的 突然发作是什么意思 ? 病人:我所说的 突然发作 是指我突然不醒人事,摔倒地上。 医生:您的发作是什么时候开始的 ? 病人:在我结婚时,当时我才 25 岁。 医生:至今有多少年了 ? 病人:3 年多了。 医生:每次犯病持续多长时间 ? 病人:大约 1 分钟。 医生:每次发作相隔多久 ? 病人:有时候约
13、 1个月,有时 2 个月左右。我的病发作与周围环 境相关系吗 ? 医生:平常在什么情况容易引起您的病发作 病人:很难说清楚。有一次我过马路时,忽然一辆小轿车飞快地 向我开来,当时我十分紧张,控制不住自己了。我大叫一声就什么也 不知道了。 医生:您伤着了吗 ? 病人:没有,汽车马上停下来了。我很快醒过来就回家了。 医生:还怎样发作过 ? 病人:另一次,我看一位护士给别的病人抽血,就冒汗、发软, 随后就晕过去了。 医生:在发病的时候还有什么其他的表现吗 病人:据看到我发病的人说,在我发作时,脸色苍白,大量出汗, 但是没有摔搐、大小便失禁或其他情况。 医生:您做过专门的检查吗 ? 病人:我们县医院的
14、医生对我说过,我的体格检查、心电图、胸 部和头颅的 X 线检查都正常。其他的专门检查就没有做过了。 医生:我给您做一个内科和神经科的全面检查吧。您还需要做些 进一步检查,包括脑电图和脑扫描。心电图也再做一个。这是各项检 查单,把所有的检查做完后再来门诊看病。 病人: 您让我做的都做完了。结果都出来吗 医生: 结果出来了,结果都正常。 病人: 那我的 突然发作 是怎么回事 ? 医生:根据内科、神经科以及一些其他专门检查看来,您既不是 器质性的心脏病或颅脑病,也不是颠痫。您突然发作时的病状和体征, 如心跳、苍白和过多的血汗等,跟您自主神经系统功能失调是相符的。 自主神经系统的功能失调能引起心博出量的减少、脑贫血、大脑功能 抑制,最后失去知觉。象这样的病我们就称做晕厥。 病人:您能用什么药治
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