一二三院合堂-2017五年制医学英语专外

ChapterChapterthe第17 腹吉林大 联谊医院风湿免疫associateRheumatologyDept.ofChina-JapanUnionHospitalofJilinReviewofSpecificThemostcommonsymptomsofabdominaldiseaseareasThemost和mostThemost:(many,much的 Whichofyouhasmadethemostmistakes?当中谁错得最多Mostbirdscan疼搔痒NauseaandChangeinbowelRectalAbdominalPainisprobablythemostimportantsymptomofabdominal疼痛是腹部疾病最重要的Althoughabdominalneoplasiamaybepainless,mostabdominaldiseasemanifestsitselfwithsomeamountofpain.尽管腹部肿瘤可以是无痛性的，但是大部分腹部疾病表现出一定程度的疼痛。 新的，现代-生长、形-没有、n.临床表FeverisonemanifestationofPaincanresultfrommucosalirritation,smoothmusclespasm,peritonealirritation,capsularswelling,ordirectnerve疼痛可以是由于粘膜的刺激、平滑肌痉挛、腹膜刺激，包膜肿胀，或者直接的神经刺激所引起。疼痛可以是由于粘膜的刺激、平滑肌痉挛、腹膜刺激，包膜肿胀，或者直接的神经刺激所引起。smoothmuscleskeletalmuscle周Abdominalpainnecessitatesforspeedydiagnosis腹部疼痛需要迅速 和治疗Thetwodoctorsmadedifferentdiagnosisofmydisease. usedtodiagnoseavarietyof 治 近义词therapy指更系统 、治treatment治Physicaltherapyalternateswith理疗和化疗交替进行Theearlierthetreatmentisgiven,thebetterthepatient's越早接受治疗，康复的可能性就越大“抱怨”“诉苦”。指心中对人或事物不满或身体感到不适或痛苦而对别人诉说或抱怨“抱怨”“诉苦”。指心中对人或事物不满或身体感到不适或痛苦而对别人诉说或抱怨有时也可表示说话者引起别人对此事的注意。用作不及物动词时,其后可接of或about引起的短语,of后常是诉苦的内容,可为名词或动名词而about后则是对抱怨事物概括的陈述。当表示“向…抱怨…”时,要用complaintosb〔aboutsth结构表诉说plainabout〔 〕应plainofSheisalwayscomplainingofhertoothachetothedoctor.她老是跟大夫说她牙痛Whenapatientcomplainsofabdominalpain,askthefollowingquestions:当患者主诉腹痛时，应该询问下列问题‘‘Whereisthepain?’’‘‘Hasthepainchangeditslocationsinceitstarted?’’‘‘Doyoufeelthepaininanyotherpartofyourbody?’’‘‘Howlonghaveyouhadthepain?’’‘‘Haveyouhadrecurrentepisodesofabdominalpain?’’周期性、再发 又、再reinstallre-‘‘Didthepainstartsuddenly?’’‘‘Canyoudescribethepain?Isitsharp?dull?burning? ‘‘Isthepaincontinuous?Doesitcomeinwaves?’’疼痛是持续的吗？它的强度是否有波动‘‘Hastherebeenanychangeintheseverityornatureofthepainsinceitbegan?’’从疼痛开始发作，它的强度和性质是否有任何变化‘‘Whatmakesitworse?’’‘‘Whatmakesitbetter?’’是什么使情况变得更好‘‘Isthepainassociatedwithnausea?vomiting?sweating?constipation?diarrhea?bloodystools?abdominaldistention?fever?chills?eating?’’ ‘‘Haveyoueverhadgallstones?kidneystones?’’ Ifthepatientisawoman,askthis‘‘Whenwasyourlastperiod?’’ 期Doyougetpainbeforeorduringyourperiods？ Notetheexacttimeatwhichthepainstartedandwhatthepatient ngatthattime.注意疼痛开始的准确时间以及疼痛开始时患者在做什么Sudden,severepainawakeningapatientfromsleepmaybeassociatedwithacuteperforation,inflammation,ortorsionofanabdominalorgan. perforation穿Thispreventsbowelperforation.这样可以防止肠道穿孔inflammation炎Hehasaninflammationofthe 他得 torsion扭Thisovaryisdarkandenlargedfromhemorrhagefollowing扭转造 而变黑变大biliarybiliary胆的、胆汁Fors,includingchildren,thebiliarytubingischokedwith有许多人包括儿童，胆道都有胆石堵塞着renal肾脏Deathusuallyresultsfromhepaticorrenal Astoneinthebiliaryorrenaltractalsocausesintense胆管或泌尿系统发 可引起剧烈的疼痛Noteacutenessofthe注意疼痛的剧烈程度Acuteruptureofafallopiantubebyanectopicpregnancy,perforationofagastriculcer,peritonitis,andacutepancreatitiscausesuchseverepainthatfaintingmayresult. gastricgastriculcer -itis炎症peritonitis腹膜炎pancreatitis胰腺炎rupureHediedofaruptureofblood-vessels.fallopianItiscrucialtodeterminethelocationofthepainatitsonset,itslocalization,itscharacter,anditsradiation.确定疼痛的起始部位、定位、性质和发射性是非常重要的Commonly,whenanabdominalorganruptures,painisfelt‘‘alloverthebelly,’’withoutlocalizationtoaspecificarea. Painarisingfromthesmallintestineiscommonlyfeltintheumbilicalorepigastricregions;forexample,painfromacuteappendicitisbeginsattheumbilicus.来源于小肠的疼痛通常位于脐部或上腹部；例如急性阑尾炎的疼痛起始于脐周。 肚脐 在.....之上；epigastric上腹部；appendicitis阑尾Aftertime,pain elocalizedtoother经过一段时间，疼痛可能定位到其他位Painfromacuteappendicitistravelsfromtheumbilicustotherightlowerquadrantinabout1to3hoursaftertheinitial急性阑尾炎在发病的1-3小时后疼痛可以从脐部转移Paininthechestfollowedbyabdominalpainshouldraisethesuspicionofadissectingaorticaneurysm.继发于胸痛的腹痛应该警惕主动脉瘤破裂的可aorticaortic大动脉的aneurysm动脉Notethenatureofthe注意疼痛的性质Paincausedbyaperforatedgastriculcerisoftendescribedas‘‘burning’’;dissectinganeurysmas‘‘tearing’’;intestinalobstructionas‘‘grip ’’;pyelonephritisas‘‘dull,aching’’;andbiliaryorrenalcolicas‘‘crampy,胃溃疡穿孔引起的疼痛通常被描述为“烧灼感”；动脉瘤破裂通常被描述为“述为“钝痛”，胆道或肾脏疼痛描述为“痉挛性、压榨性”。intestinalintestinal的；pyelonephritis[ˌpaɪəloʊnɪ'fraɪtɪs]肾盂肾炎colic：疝气、急腹描述疼痛 Referredpainoftenprovidesinsightastothe牵涉痛经常能够提供病因的线索Referredpainisatermusedtodescribepainoriginatingintheinternalorgansbutdescribedbythepatientasbeinglocatedintheabdominalorchestwall,shoulder,jaw,orotherareas dbythesomaticnerves. somaticsomatic身体的、躯体Painappearstooriginateinareas dbythesomaticnervesenteringthespinalcordatthesamesegmentasthesensorynervesfromtheorganresponsibleforthepain. Forexample,right-shoulderpainmayresultfromacutecholecystitis;testicularpainmayresultfromrenalcolicorfromappendicitis.例如，急性胆囊炎引起右肩痛，肾绞痛或阑尾炎引 痛spinalspinalcord脊髓；sensorynerves感觉神经cholecystitis胆囊炎 的ThecommonsitesforreferredpainareshowninFigure17-常见的牵涉痛部位见图17-3Thelocationsofpain常见的牵涉痛部位见图17-3腹腹部疾病的疼痛定位归纳于表17-2Thetimeofoccurrenceandfactorsthataggravateoralleviatesymptoms(e.g.,mealsordefecation)areparticularlyaggravateaggravate：加重；alleviate：减Periodicepigastricpainoccurring1/2to1houraftereatingisaclassicsymptomofgastricpepticulcers.患有十二指肠溃疡疼痛多在进食后2-3小时或下次进餐前出现患有十二指肠溃疡疼痛多在进食后2-3小时或下次进餐前出现进食后半小时到1小时出现周期性上腹痛是胃溃疡的典型症状gastricpepticulcersgastricpepticulcers：消化性胃溃疡duodenalpepticulcer：消化性十二指肠溃疡patientswith:患有......Foodtendstolessenthepain,especiallyinduodenal十二指肠溃疡穿孔至胰腺可以导致后背痛，看似矫形十二指肠溃疡穿孔至胰腺可以导致后背痛，看似矫形外科问题特别是十二指肠溃疡，食物能够减轻疼痛orthopedicorthopedic[ɔːθə'piːdɪk]整形外nocturnal：nocturnal：夜间内脏Nocturnalpainisaclassicsymptomofduodenalpepticulcer十二指肠溃疡的典型症状是夜间痛Painaftereatingmayalsobeassociatedwithvasculardiseaseoftheabdominalviscera.腹 的血管类疾病也可伴随进食后疼痛Patientswiththisconditionareolderandhavepostprandialpain,anorexia,andweightloss.这类患 较大，伴有餐后痛、厌食和消瘦Thistriadisseeninabdominalanginaresultingfromobstructivevasculardiseaseintheceliacaxisorthesuperiormesentericartery.这一三联症见于腹腔干或肠系膜上动脉的血管阻塞类疾病引起的腹绞痛。post-post-:后面的；postprandial：餐后anorexia：厌食triad：三个一angina：[æn'dʒaɪnə]绞celiacaxis：腹腔superiormesentericartery：肠系膜上动Table17-3summarizestheimportantmaneuversforamelioratingabdominalpain.表17-3表17-3NauseaandVomitingmaybecausedbysevereirritationof resultingfromtheperforationofanabdominalorgan;fromobstructionofthebileduct,ureter,orintestine;orfromtoxins. Vomitingresultingfromaperforationisrarely穿孔引起 很少是大量的bileductbileduct：胆管NauseaandObstructionofthebileductorothertubeproducesstretchingofthemuscularwall,resultinginepisodicvomitingthatoccursattheheightofthepain. Intestinalobstructionpreventstheintestinalcontentsfrompassingdistally;consequently,vomitingmayresultintheexpulsionofintestinalcontents.肠道梗阻阻碍肠内容物经肠道排出，随 导致肠内容的排出distallydistally['dɪstælaɪ]远expulsion：排emergency：紧急事emergency：紧急事科Toxinsgenerallycausepersistent毒素通常引起持续 Notallabdominalemergenciescause不是所有的腹部急症都导 NauseaandIntraperitonealbleedingmayoccurintheabsenceof腹腔内 往往没 症状Vomitingisfrequentlyalsocausedbyinflammationofintra-abdominalstructures,aswellasbyextra-abdominalconditions,includingdrugtoxicity,centralnervoussystemdisorders,myocardialinfarction,andpregnancy. 的； 外部NauseaandAskthefollowingquestionsifapatientcomplainsofnausea,vomiting,orboth: ‘‘Howlonghaveyouhadnauseaorvomiting?’’ ‘‘Whatisthecolorofthe 物是什么颜色‘‘Isthereanyunusuallyfoulodortothevomitus?’’ Nauseaand‘‘Howoftendoyouvomit?’’ ‘‘Isvomitingrelatedtoeating?’’Ifyes,‘‘Howsoonaftereatingdoyouvomit?Doyouvomitonlyaftereatingcertainfoods?’’ Howoften：多久一Howoftendoyougotochurch你隔多久去Howoften：多久一Howoftendoyougotochurch你隔多久去做一次礼拜Howsoon：多快，多久以HowsooncanIbereleasedfromthehospital?什么时候才能出院Nauseaand‘‘Isthenauseaorvomitingassociatedwithabdominalpain?constipation?diarrhea?alossofappetite?achangeinthecolorofyourstools?achangeinthecolorofyoururine?fever?chestpain?’’ ‘‘Haveyounoticedachangeinyourhearingability?’’ ‘‘Haveyounoticedringinginyour“你是否存在耳鸣NauseaandIfthepatientisawoman,askthis如果患者为女性，应询问‘‘Whenwasyourlastperiod?’’ Therelationshipofthepaintovomitingisimportantandmayhelpinprovidingthediagnosis.疼痛 的关系非常重要，有可能有助 NauseaandInacuteappendicitis,painprecedesthevomitingusuallybyafewhours.急性阑尾炎时，疼痛通常 前几小时发生Thecharacterofthevomitusmayaidindeterminingits物的特点可以帮助明确病因Acutegastritiscausesthepatienttovomitstomach急性胃炎可导致患 胃内容物-itis炎症；gastr的、肮脏的、臭Biliarycolicproducesbilious,orgreenish-yellow胆绞 物为胆汁，或黄绿色物质Intestinalobstructionoftencausesthepatienttoexpelbiliousvomitus,followedbyfeculent-smellingfluid. Feculentvomitusisusuallycausedbyintestinalobstruction. NauseaandNauseawithoutvomitingisacommonsymptominpatientswithhepatocellulardisease,pregnancy,andmetastatic 通常是肝细胞疾病、怀孕和代谢疾病患者的常见症状NauseamaybeassociatedwithahearinglossandtinnitusinpatientswithMe´nie`re’sdisease. 丧失和耳鸣常提示美尼尔病hepato-肝tinnitus：['tɪnɪtəs]耳ChangeinBowelTakeacarefulhistoryofbowel注 排 的详细病史Achangeinbowelmovementsnecessitatesfurther排便变化需要更详尽的描述Askthesequestionsofthepatientwithacuteonset急性腹泻患者需要询问如下问题bowelhabitsbowelhabits：肠道排便ChangeinBowel“你腹泻多久了‘‘Howlonghaveyou“你腹泻多久了“你一天排便多少次‘‘Howmanybowelmovementsdo“你一天排便多少次‘‘DidthediarrheastartChangeinBowel‘‘Didthediarrheabeginafterameal?’’Ifyes,‘‘Whatdidyoueat?’’‘‘Arethestoolswatery?bloodymalodorous?’’‘‘Isthediarrheaassociatedwithabdominalpain?lossappetite?nausea?“腹泻是否伴有腹痛？食欲下降 malodorousmalodorous：恶臭mal-坏的ChangeinBowelTheacuteonsetofdiarrheaafteramealsuggestsanacuteinfectionortoxin.进餐后急性发作的腹泻提示 染 Waterystoolsareoftenassociatedwithinflammatoryprocessesofthesmallbowelandcolon.水样便常提示小肠或结肠的炎症过程Shigellosisisadiseaseofthecolonthatproducesbloody痢疾是一种伴发血样便腹泻的结肠疾病coloncolon：结Shigellosis：[ˌʃɪgə'loʊsɪs]志贺氏细菌性痢ChangeinBowel阿米巴病也伴发血样便腹泻Amebiasis阿米巴病也伴发血样便腹泻慢性腹泻的患者应询问如下问题Thepatient慢性腹泻的患者应询问如下问题 阿米巴ChangeinBowel“腹泻多久了‘‘Howlonghave“腹泻多久了“腹泻是否与便秘交替出现‘‘Doyouhave“腹泻是否与便秘交替出现“大便呈水样？松散的？呈漂浮状？“大便呈水样？松散的？呈漂浮状？带有恶臭气味ChangeinBowel‘‘Haveyounoticedbloodinthestools?mucus?undigestedfood?’’“你是否注意到便中带血？带粘液？“你是否注意到便中带血？带粘液？含有未消化的食物“大便是什么颜色的‘‘Howmanybowelmovementsdo“大便是什么颜色的“腹泻出现在进食后mucus：粘液“腹泻出现在进食后mucus：粘液“你每天排便几次ChangeinBowel‘‘Whathappenswhenyoufast?Doyoustillhave“当你禁食后发生了什么情况？你是否还存在腹泻‘‘Isthediarrheaassociatedwithabdominalpain?abdominaldistention?nausea?vomiting?’’“腹泻是否伴随腹痛？腹胀 ‘‘Haveyounoticedthatthediarrheaisworseatcertaintimesoftheday?’’“你是否注意到腹泻在每天的固定时间变得更加严重fastfast：斋戒、禁ChangeinBowel“你的食欲如何‘‘How“你的食欲如何“你的体重有无改变‘‘Hastherebeenany“你的体重有无改变ChangeinBowel腹泻和便秘交替出现常见于结肠癌或腹泻和便秘交替出现常见于结肠癌或憩室炎患者Loosebowelmovementsarecommonindiseasesofthecolon,whereaswaterymovementsareseeninsevereinflammatoryboweldiseaseandprotein-losingenteropathies.Loosebowelmovements：腹泻ChangeinBowelFloatingstoolsmayresultfrommalabsorption浮浮便是由于吸收不良综合征导致的Patientswithulcerativecolitiscommonlyhavestoolwithbloodand溃疡溃疡性结肠炎患者通常大便中混有血和粘液colitis：结肠ChangeinBowel任何炎症性小肠疾病或结肠疾病表现为大便混任何炎症性小肠疾病或结肠疾病表现为大便混有血或未消化的食物Irritablebowelsyndromeclassicallyproducesmoreinthe肠激肠激惹综合征典型的表现是清晨频繁腹Irritable：易怒的、急躁ChangeinBowel患者主诉便秘应该询问下列问题Patients患者主诉便秘应该询问下列问题“你发生便秘多久‘‘Howlong“你发生便秘多久“多长时间排便一‘‘Howoftendoyou“多长时间排便一“大便条的长度是多少‘‘Whatis“大便条的长度是多少ChangeinBowel‘‘Whatisthecolorofyour““大便是什么颜色‘‘Isthestoolevermixedwithblood?““大便是否曾混有血？粘‘‘Haveyounoticedperiodsofconstipationalternatingperiodsof““腹泻和便秘是否交替出‘‘Haveyounoticedachangeinthecaliberofthe““大便条的粗细是否发生了改变ChangeinBowel‘‘Doyouhavemuch““你是否有涨气‘‘How’syour““食欲如何‘‘Hastherebeenanychangeinyour““体重是否发生了变化Changeinthecaliberofthestoolis大大便条粗细的变化是有意ChangeinBowel‘‘Pencil’’-diameterstoolsmayresultfroman oradistalrectalcarcinoma. Achangeinthecolorofstoolsisimportant.Asisdiscussedlater,palebrowntograystoolsindicateabsenceof正如下文将要讨论的，浅棕色至灰色的大便提示胆汁ChangeinBowel这可能是由于胆汁从胆囊流出通道梗阻或胆汁产生减少这可能是由于胆汁从胆囊流出通道梗阻或胆汁产生减少所致Weightchangesareimportantwiththesymptom体重体重改变是便秘重要的伴随症状gallbladder：胆囊ChangeinBowelAnincreaseinweightmayindicatedecreasedmetabolismseeninhypothyroidism;体重增加提示新陈代谢减慢见于甲状腺功能减adecreaseinweightmaybeassociatedwithcancerofthecolonorotherhypermetabolicconditions.体重降低可能见于结 或其他高代谢情况MetabolismMetabolismHypothyroidism：[ˌhaɪpoʊ‘θaɪrɔɪdɪzəmRectalRectalbleedingmaybemanifestedbybrightredblood,bloodmixedwithstool,orblack,tarrystools.直肠 可以表现为鲜红色的血，便中混有血，或者黑色、柏油便。Brightredbloodperrectum,alsoknownashematochezia,canoccurfromcolonictumors,diverticulardisease,orulcerativecolitis.经直肠排出鲜红色血，也称为便血，见于结肠肿瘤、憩室疾病、或溃疡性结肠炎。RectalRectal：直肠的]hema-：血RectalBloodmixedwithstoolcanbetheresultofulcerativecolitis,diverticulardisease,tumors,orhemorrhoids.便中混有血见于溃疡性结肠炎、肿瘤、或痔Askthepatientwhodescribesrectalbleedingthefollowing对于直 的患者应询问如下问题Hemorrhoids：[‘hemərɔɪdzRectal‘‘Howlonghaveyounoticedbrightredbloodinyour““你注意到大便中有鲜红色血有多久了‘‘Isthebloodmixedwiththe“血液是混在大便中吗‘‘Aretherestreaksofbloodonthesurfaceofthe““大便表面是否有血液Rectal‘‘Haveyounoticedachangeinyourbowel“你是否注意到你的排 发生了变化‘‘Haveyounoticedapersisten sationinyourrectumthatyouhavetomoveyourbowels,butyoucannot?’’“你是否持续感觉到不得不排便但却排不出来Tenesmusisthepainful,continued,andineffectiveat里急后重是指在排便时疼痛的、持续而无效的RectalItiscausedbyinflammationoraspace-occupyinglesionsuchasatumoratthedistalrectumoranus.它是由炎症或空间占位损害如直肠末端 部位的肿瘤所引起Hemorrhoidalbleedingisacommoncauseofhematocheziaandstreakingofstoolwithblood.痔 是便血和大便带血的常见原因LesionLesion：[‘liːʒn]损害、损伤hematochezia：[hemətə‘kiːzɪə]便RectalMelenaisablack,tarrystoolthatresultsfrombleedingabovethefirstsectionoftheduodenum,withpartialdigestionofthehemoglobin. MelenaMelena：[mə'liːnə]黑便duodenum：[ˌduːə‘diːnəm]十二指肠Hemo-血；-globinRectalInquireaboutthepresenceof应应了解黑便存在的Ausefulwayofquestioningistoshowthepatientthetubingonthestethoscopeandask,‘‘Haveyourbowelmovementseverbeenthiscolor?’’一种有效地询问方法是向患者展示听诊器的黑管并问，“你的大便一种有效地询问方法是向患者展示听诊器的黑管并问，“你的大便是否有过这种颜色？”Stethoscope：[‘steθəskoʊp]RectalIfaskeddirectlywhetherthebowelmovementshaveeverbeenblack,thepatientmayanswerintheaffirmative,equatingdark(normal)stoolswithblackstools.如果直接询问患者是否有过黑色大便，患者的答复往往是肯定的，他们把正常暗色的大便等同于黑便。如果直接询问患者是否有过黑色大便，患者的答复往往是肯定的，他们把正常暗色的大便等同于黑便。Equating：等同于；～withRectalAskthesequestionsofapatientwhodescribes如如果患者描述有黑便应询问下列‘‘Haveyoupassedmorethanoneblack,tarrystool?’’If““是否排过多次黑色、柏油样大便？”如果是，“什么时候‘‘Howlonghaveyoubeenhavingblack,tarry““排黑色、柏油样便多久Rectal‘‘Haveyounoticedfeeling“是否曾感觉头昏眼花‘‘Haveyouhadanynauseaassociatedwiththesestools?anyvomiting?diarrhea?abdominalpain?sweating?’’“排便时是否伴 ？腹泻？腹痛？出汗LightheadedLightheaded：头昏眼花RectalTheanswerstothesequestionscanprovidesomeinformationregardingtheacutenessandtheamountofthe这些问题有助于提供关 的急性程度 量的相关信息Lightheadedness,nausea,anddiaphoresisareseenwithrapidgastrointestinalbleedingandhypotension.头昏 和出汗提示快速胃肠 和低血压Diaphoresis:[ˌdaɪəfə‘riːsɪs]出汗Gastrointestinal：gastro-胃的intestinal肠的RectalThepresenceofsilver-coloredstoolsisrarebutpathognomonicofacholicstoolswithmelena,aconditionresultingfromcanceroftheampullaofVaterinthe银色便很少见但特异性的提示患者便中无尿胆原并伴有黑便，提十二指肠泛特氏 癌。Thecancerproducesbiliaryobstruction,andthefrondsaresloughed,causingPathognomonic：特殊病症的、特异的Acholic：无胆汁的；anotcholic胆汁的FrondPathognomonic：特殊病症的、特异的Acholic：无胆汁的；anotcholic胆汁的FrondThepresenceofjaundice(icterus)mustalerttheexaminerthatthereiseitherliverparenchymaldiseaseoranobstructiontobileflow.存在黄疸提醒检查者患者或者存在肝细胞疾病或者存在胆汁排出梗存在黄疸提醒检查者患者或者存在肝细胞疾病或者存在胆汁排出梗阻。Jaundice:Jaundice:Icterus：[‘ɪktərəs]parenchymal：[pə‘rəŋkəməl]黄疸的出现是由于流入胆汁的结合型黄疸的出现是由于流入胆汁的结合型胆红素减少引起Thiscanresultfromintrahepaticbiliaryobstruction,asmedicaljaundice,orfromextrahepaticbiliaryobstruction,knownassurgicaljaundice.黄疸的病因包括肝内胆管梗阻导致的内科黄疸，和肝外胆管梗阻导致的外科黄疸。黄疸的病因包括肝内胆管梗阻导致的内科黄疸，和肝外胆管梗阻导致的外科黄疸。conjugatedbilirubin：结合型胆红素Intra-内的；extra-外的“黄疸“黄疸是否发展迅对于任何黄疸患者，检查者应该询问如下问题以寻找对于任何黄疸患者，检查者应该询问如下问题以寻找疾病线索：‘‘Howlonghaveyoubeen““黄疸发生‘‘Didthejaundicedevelop‘‘Isthejaundiceassociatedwithabdominalpain?lossappetite?nausea?vomiting?distastefor“黄疸是否伴有腹痛？食欲减退 ？讨厌香烟‘‘Isthejaundiceassociatedwithchills?fever?itching?weightloss?’’“黄疸是否伴有寒战？发热？搔痒？体DisDistaste：不喜欢、厌恶，dis‘‘Inthepastyearhaveyouhadanytransfusions?tattooing?在过去一年里你是否曾经输液？纹身？接 Inoculation‘‘Doyouuseanyrecreationaldrugs?’’Ifyes,‘‘Doyouuseanydrugsintravenously?’’ ‘‘Doyoueatraw fish?“你是否使用生的贝类食品？牡recreationalrecreationaldrugs：消遣性 “Haveyoutraveledabroadinthepastyear?”Ifyes,“Where?Wereyouawarethatyoumayhaveconsumedunclean“过去的一年中你是否出过国？”如果是，“你去过哪里？你是否知道你可能使用过 净的水？”‘‘Haveyoubeenjaundiced““既往是否有黄疸病史‘‘Hasyoururinechangedcolorsinceyounoticedthatwere““出现黄疸后，你的尿液颜色是否发生改变‘‘Whatisthecolorofyour““大便是什么颜色‘‘Doyouhaveanyfriendsorrelationswhoarealso“你是否有朋友或亲属也发生了黄疸‘‘Whattypeofworkdoyoudo?Whatothertypesofworkhaveyoudone?’’“你从事何种工作？你曾经从事过何种工作‘‘Whatareyour“你的业 是什么Viralhepatitisisassociatedwithnausea,vomiting,alossofappetite,anda siontosmoking.性肝炎伴 、食欲减退、和讨厌吸烟HepatitisAhasafecal-oralrouteoftransmissionandanincubationperiodof2to6weeks.甲型肝炎是通过粪—口途 ，潜伏期是2-6周aversionaversionHepatitis：肝炎；hepat：肝的；-itisItmaybelinkedtoingestionofraw 它可能与摄入生的贝类食物有关HepatitisBisblood-borneandhasanincubationperiod