胸外科病例讨论英文版
心胸外科病例讨论
第7期疑难病例讨论患儿，性别男，年龄4月，因“咳嗽喘息10天，加重伴气促4天”于2017.08.20入院。
临床表现：患儿于10天前出现咳嗽，为阵发性干咳，伴喘息，伴有喉鸣，咳嗽剧烈时并有阵发性面色发红现象，无发热，无气促发绀，起病后在家口服药物治疗（抗病毒口服液、小儿氨酚黄那敏颗粒、咳喘灵颗粒），无明显好转，4天前出现加重，伴有气促，无发绀，遂在当地A院住院治疗（具体诊治不详）4天，无缓解，咳嗽较前明显增多，遂到“A院”就诊，完善心脏彩超提示“先天性心脏病”，建议家属上级医院进诊治，为求进一步诊治至B院就诊。
起病以来患儿精神反应一般，食欲差，睡眠差，哭吵不安，目前有腹泻，解黄绿色稀水便，3-4次/天，小便量可。
入院体查：SPO2:90%.发育正常，营养不良，急性面容，自主体位，哭吵，神志清楚，查体不合作。
肤色粉红，肤色全身皮肤粘膜无黄染，弹性正常，无皮疹、皮下出血、皮下结节、瘢痕，无肝掌、蜘蛛痣，皮下无水肿，毛发分布正常，无溃疡。
全身浅表淋巴结无肿大。
头颅无畸形、压痛、包块，前囟平软，1.0cm×1.0cm,无眼睑水肿，结膜正常，眼球正常，巩膜无黄染，瞳孔等大同圆，直径2.5mm，对光反射正常，外耳道无异常分泌物，乳突无压痛，口唇无发绀，口腔粘膜正常。
咽部粘膜充血，扁桃体无肿大，腮腺正常。
颈软无抵抗，颈动脉搏动正常，颈静脉正常，气管居中，肝颈静脉回流征阴性，甲状腺正常，无压痛、震颤、血管杂音。
胸廓正常，胸骨无叩痛，乳房正常对称。
呼吸运动正常，肋间隙正常，叩诊清音，呼吸规整，呼吸急促，可见三凹征。
双肺呼吸音粗，可闻及哮鸣音，无胸膜摩擦音。
心前区无隆起,心尖搏动点左乳线处,心尖搏动正常,无心包摩擦感。
心率156次/分、心律齐、心音有力、各瓣膜区可闻及4/6级收缩期吹风样杂音，有传导、无心包摩擦音。
腹平坦，无腹壁静脉曲张，腹部柔软，无压痛、反跳痛，腹部无包块。
肝脏未触及，脾脏未触及，肾脏无叩击痛，无移动性浊音。
英文病例写作范文阅读带翻译
英文病例写作范文阅读带翻译病例写作是医生日常的工作，英文的病例该如何写呢，接下来店铺为大家整理英文病例写作范文，希望对你有帮助哦!英文病例写作范文篇一Name: Joe Bloggs (姓名：乔。
伯劳格斯)Date: 1st January 2000(日期：2000年1月1日)Time: 0720(时间：7时20分)Place: A&E(地点：事故与急诊登记处)Age: 47 years(年龄：47岁)Sex: male(性别：男)Occupation: HGV(heavy goods vehicle ) driver(职业：大型货运卡车司机)PC(presenting complaint)(主诉)4-hour crushing retrosternal chest pain(胸骨后压榨性疼痛4小时)HPC(history of presenting complaint)(现病史)Onset: 4 hours of “crushing tight” retrosternal chest pain, radiating to neck and both arms, gradual onset over 5-10 minutes.(起病特征：胸骨后压榨性疼痛4小时，向颈与双臂放射，5-10分钟内渐起病)Duration: persistent since onset(间期：发病起持续至今)Severe: “worst pain ever had”(严重性：“从未痛得如此厉害过)Relieving/exacerbating factors缓解与恶化因素GTN(glyceryl trinitrate) provided no relief although normally relieves pain in minutes, no other relieving/exacerbating factors.(硝酸甘油平时能在数分钟内缓解疼痛，但本次无效，无其它缓解和恶化因素。
胸外科病案讨论病案讨论
002．答案要点：根据该病人的临床表现、 体格检查及辅助检查结果，可临床诊断为 胸壁结核并寒性脓肿。由于低热、盗汗， 血沉为40mn／h，应先行抗结核治疗并反复 行脓肿穿刺，抽尽脓液并注入抗结核药。 如效果不好，可待病人一般情况改善及血 沉恢复正常后行手术治疗，术中彻底切除 病变组织，清洗后用肌瓣充填残腔，并撒 人青、链霉素粉预防感染。术毕加压包扎。
004．答案要点 临床诊断为左肺上叶周围型肺癌(T2NoMo， IB期)。治疗：择期行左肺上叶切除+肺门纵隔淋巴结清扫。
术后根据病理结果、细胞类型、淋巴结有无镜下转移等决 定是否进行术后化疗。
005．男性50岁，因咳嗽、咳痰带血丝一月 余人院。吸烟30年，每日30支。体检：一般
情况好，颈及锁骨上均未触及淋巴结，心 肺腹未见异常。x线胸片示左肺门肿块阴影。
试述初步诊断，提出进一步特殊检查项目 (至少四项)及其目的?
005．答案要点 初步诊断为左肺中心型肺癌。根据是：① 痰中带血丝；②长期大量吸烟史；③左肺门阴影。但需要 与其他也可引起痰中带血丝的疾病如肺结核、肺炎、支扩 等相鉴别。还应怀疑造成肺部阴影的疾病如纵隔肿瘤。进 一步检查包括：①胸部CT检查：观察肺门肿块阴影的影像 学特点，左肺支气管有无狭窄阻塞，进一步寻找支持中心 型肺癌诊断和排除其他可疑疾病的根据，并可明确纵隔淋 巴结转移，为肺癌的分期和手术方式选择提供证据；②纤 维支气管镜检查：可能直接观察到左侧支气管内的肿瘤， 并可能取活检或刷片以进一步明确诊断和肿瘤细胞类型， 并根据肿瘤的部位、侵犯支气管的范围指导手术方式的选 择；③骨扫描：排除全身肿瘤骨转移；④有条件时可行全 身PET检查协助明确肿块的性质和全身有无转移；⑤肺功 能检查：为手术选择作准备。
003．答案要点：病人起病咳嗽、右侧胸痛。x线 检查显示右侧胸膜炎并少量胸腔积液。胸膜腔穿 刺抽出淡黄色清亮液体。初步诊断为结核性胸膜 炎并胸腔积液。可作结核菌素试验、血沉、胸液 涂片找抗酸杆菌或胸液作结核菌培养等以明确诊 断。突发高热、呼吸困难、白细胞增高、胸腔积 液增多应怀疑合并细菌感染。若胸腔穿刺抽得脓 液，可诊断为脓胸。观察脓液外观性状，质地稀 稠，有无臭味，并作涂片镜检、细菌培养及药物 敏感试验，选用敏感抗生素。反复行胸膜腔穿刺 排净脓液；同时给予全身支持治疗，如补充营养 和维生素、注意水和电解质平衡、纠正贫血等。
医学影像英文读片病例分析
She underwent biopsy of the sinonasal mass which revealed prominent sclerosis and dense lymphoplasma cell infiltrate. Immunohistochemistry revealed IgG4 plasma cells constituting 50% of IgG plasma cells and IgG4-positive cells >30/hpf, which was consistent with IgG4-related sclerosing disease.
Figure 1 (A-C): A 15-year-old female with recurrent epistaxis and nasal obstruction. MRI T2W axial and coronal (A, B) images revealed T2-hypointense soft tissue thickening (arrows in A, B) involving the nasal septum and right lateral nasal wall, with extension into the right maxillary sinus (arrow in B). Post-contrast T1W axial image (C) revealed heterogeneous enhancement of lesion (arrow) with central hypoenhancing regions. Biopsy with immunohistochemistry of lesion and raised serum IgG4 levels confirmed the diagnosis of IgG4-related disease
胸外科疑难病例讨论记录范文模板
胸外科疑难病例讨论记录范文模板英文回答：Case Presentation:The patient is a 45-year-old male with a history of smoking and chronic cough. He presents with a 6-month history of worsening shortness of breath and chest pain. Imaging studies revealed a large mass in the right lung, and a biopsy confirmed the presence of non-small cell lung cancer. The patient's case is complicated by the involvement of nearby lymph nodes and possible metastasis to the liver.Discussion:The management of this patient's lung cancer is challenging due to the advanced stage of the disease and the presence of metastasis. Surgical resection may not be feasible, and the patient may require a combination ofchemotherapy, radiation therapy, and targeted therapy. The involvement of a multidisciplinary team including medical oncologists, radiation oncologists, and thoracic surgeonsis essential for developing an individualized treatment plan.English response:The patient's smoking history and the advanced stage of the disease pose significant challenges in the managementof his lung cancer. It will be important to discuss the potential benefits and risks of different treatment options with the patient and involve him in shared decision-making. Palliative care should also be considered to address the patient's symptoms and improve his quality of life.中文回答：患者的吸烟史和疾病的晚期阶段使他的肺癌治疗面临重大挑战。
胸外病例讨论一、二(完整)
Guangdong medical college
术后常见问题处理
• • • •
原发病处理. 疼痛 清理呼吸道 引流不畅:观察引流管情况,2 h/ 次。将插管与皮 肤接触处做好标记,观察是否有引流管脱出,每2 h 挤压胸腔引流管1 次。发现引流液突然减少,要查 找原因,将引流管的位置进行调整,或嘱病人变换体 位,确定其是否通畅。
Guangdong medical college
辅助检查
• 胸相（正侧位）：左侧肺组织压缩，向肺
门处回缩，但上肺在二三肋间处与胸壁有 粘连存在，肺组织压缩约90%。（见下图）
Guangdong medical college
• 2006-10-01胸相（正侧位）
Guangdong medical college
Guangdong medical college
Guangdong medical college
分析思考与讨论
• 1、该患者最可能的诊断是什么? • 2、需要通过哪些方法来明确诊断? • 3、对该患者需要进行哪种手术? • 4、该手术的手术指征是什么?
Guangdong medical college
4.引流管要求被水封闭，不能开放。
Guangdong medical college
A
B
C
D
E
F G Guangdong medical college
胸腔闭式引流术
Thoracic closed drainage
Guangdong medical college
拔管指征：
• （1）24小时引流量少于50ml。 • • （2）X线检查肺膨胀良好。 • • （3）停止漏气24小时以后。
谈论医患关系英语作文范文
谈论医患关系英语作文范文Title: The Dynamics of Doctor-Patient Relationship。
The doctor-patient relationship is a cornerstone of healthcare, playing a pivotal role in the delivery of effective medical care and patient satisfaction. This relationship is built on trust, communication, and mutual respect, essential elements that contribute to positive health outcomes. In this essay, we delve into the various aspects of the doctor-patient relationship, its significance, challenges, and ways to strengthen it.Firstly, effective communication is paramount in fostering a healthy doctor-patient relationship. Doctors need to communicate medical information clearly and understandably, while patients should feel comfortable expressing their concerns and asking questions. Open communication facilitates shared decision-making, where patients are actively involved in their healthcare decisions, leading to better treatment adherence andoutcomes.Furthermore, trust forms the foundation of the doctor-patient relationship. Patients entrust their health and well-being to their doctors, relying on their expertise and judgment. Trust is cultivated through consistent, compassionate care, respect for patient autonomy, and maintaining confidentiality. Conversely, breaches of trust, such as medical errors or lack of empathy, can erode the patient's confidence and strain the relationship.Empathy is another crucial component of the doctor-patient relationship. Empathetic doctors can understand and resonate with their patients' emotions, offering not just medical expertise but also emotional support. Patients appreciate doctors who demonstrate empathy, feeling heard and understood amidst their health concerns. Empathy humanizes the medical encounter, fostering a connectionthat transcends the purely clinical aspect.However, despite its importance, the doctor-patient relationship faces various challenges in today's healthcarelandscape. Time constraints, administrative burdens, and the pressure to meet productivity targets can hinder meaningful doctor-patient interactions. In some cases, cultural and language barriers may impede effective communication, leading to misunderstandings and dissatisfaction.Moreover, the hierarchical nature of the healthcare system can create power imbalances within the doctor-patient relationship. Patients may feel intimidated or hesitant to question their doctors, fearing repercussions or being perceived as difficult. Addressing these power differentials requires a shift towards patient-centered care, where patients are viewed as partners in their healthcare journey rather than passive recipients of medical advice.To strengthen the doctor-patient relationship, healthcare organizations can implement various strategies. Investing in communication skills training for healthcare providers can enhance their ability to engage with patients effectively. Emphasizing patient-centered care in medicaleducation curriculum can instill values of empathy, communication, and shared decision-making in future healthcare professionals.Additionally, integrating technology into healthcare delivery can facilitate communication and streamline administrative processes, allowing more time for meaningful patient interactions. Telemedicine platforms, patient portals, and electronic health records can improve accessto care, enhance communication between doctors and patients, and empower patients to take an active role in managingtheir health.In conclusion, the doctor-patient relationship is a cornerstone of healthcare, characterized by trust, communication, and empathy. Cultivating a positive relationship enhances patient satisfaction, improves treatment adherence, and ultimately leads to better health outcomes. Despite facing challenges, concerted efforts to prioritize communication, trust, and patient-centered care can strengthen the doctor-patient relationship and enrich the healthcare experience for all involved.。
英文版病例汇报
Chest CT
Chest CT
2015.05.28 Pelvic CT
2015.05.28 Pelvic CT
Present diagnosis
Rectal cancer after resection pT4aN0M0 ⅡB
Liver metastasis
Harbin Medical University cancer hospital
Present history
Tumor marker after Chemotherapy
CEA CA199
2015.05.29
Before chemotherapy
113.2
168.2
135.3
157.7
CEA：0-5ng/ml CA199:0-37U/ml
2015.06.23
1 course later
Harbin Medical University cancer hospital
Present history
Recurrence
• 2015-06-01 Left liver lesion biopsy: Poorly differentiated carcinoma, consistent with metastatic carcinoma.
Harbin Medical University cancer hospital
Present history
Clinical diagnosis based on the pathologic
stage Rectal adenocarcinoma after resection pT4aN0M0 ⅡB
Harbin Medical University cancer hospital