第六章耳鼻喉科答案DialogueInterpretingDoctor:請進，奧斯汀女士，您今天感覺怎么樣？Client:Notverywell,doctor,orIwouldn’tbehere.Iwishthiswerejustacasualchat,butunfortunatelyitisn’t.Doctor:那么，您哪里不舒服呢？Client:I’mnotsure.I’vehadarunnynosethesepastfewdays,myeyeskeepwatering,andthere’sared,itchyrashonmychestandneck.Doctor:是的，我能看到皮疹。讓我看看您的背部。（停頓）啊哈，是的，您似乎對某種東西過敏。Client:Allergy?Idon’tthinkI’veeverbeenallergictoanythingbefore.Whatkindofallergyisit?Doctor:在進行檢查之前，我無法確定地告訴你。但很有可能是以下三種情況之一——花粉癥、喘息性支氣管炎或成人哮喘。Client:Thatsoundsdaunting.Sowhatdothesetermsmean?Doctor:讓我先解釋一下什么是過敏。過敏是對某種物質(zhì)或多種物質(zhì)的異常敏感反應(yīng)。Client:Thenwhatishayfever?Doctor:花粉癥是一種由對花粉、霉菌或灰塵敏感引起的呼吸系統(tǒng)過敏反應(yīng)。Client:Whatarethesymptomsofhayfever?Doctor:花粉癥可能會導(dǎo)致眼睛發(fā)炎、發(fā)癢和流淚，鼻子堵塞、阻塞或流鼻涕，鼻子、眼睛、上顎和喉嚨的發(fā)癢和灼熱感。打噴嚏也是花粉癥的常見癥狀。Client:Andwhatisasthmaticbronchitis?Doctor:喘息性支氣管炎是一種氣道發(fā)炎并伴有喘息聲的疾病。Client:Andwhataboutadultasthma?Doctor:成人哮喘與支氣管阻塞有關(guān)，特點是呼吸困難。Client:Whatcausesadultasthma?Doctor:我們目前還不知道確切的原因?？赡芘c多種因素有關(guān)，甚至可能與遺傳有關(guān)。Client:HowcanyoufindoutexactlywhatIamallergicto?Doctor:我需要詳細了解您的病史，研究您在家中或工作環(huán)境中的情況、生活習(xí)慣和娛樂活動。我還可能要求做一些實驗室檢查，并進行多種皮膚測試，使用常見過敏原來檢測是否有過敏反應(yīng)。Client:Thatsoundssocomplicatedandtimeconsuming.Doctor:是的，過敏診斷是一個復(fù)雜的過程，但這是成功治療過敏的唯一途徑。Client:AndwhatshouldIdointhemeantime?Doctor:我會給您開一些抗炎藥片，可以減輕您的不適。另外，我會為您安排下一次復(fù)診。把這張條子交給我的秘書，她會告訴您下次的具體預(yù)約時間。Client:Okay.Thankyou,doctor.Consecutive/SimultaneousInterpretingPassageOne鼻竇炎鼻竇炎是指鼻竇內(nèi)壁組織的炎癥或腫脹。鼻竇是面部內(nèi)部的結(jié)構(gòu)，通常充滿空氣。當(dāng)細菌感染、病毒感染或過敏刺激這些組織時，它們可能會被堵塞并積聚液體，從而導(dǎo)致面部壓力和疼痛、鼻塞等癥狀。人體共有四對鼻竇，位于頭部內(nèi)部，它們通過狹窄的通道相連。鼻竇會分泌黏液，這些黏液通過鼻腔的通道排出，幫助保持鼻腔清潔，并防止細菌、過敏原及其他病原體的侵入。根據(jù)病程長短，鼻竇炎可分為急性、慢性和復(fù)發(fā)性鼻竇炎。急性鼻竇炎持續(xù)時間少于四周。癥狀包括鼻塞、分泌物增多、面部疼痛以及嗅覺減退。它通常由普通感冒引起。慢性鼻竇炎的癥狀持續(xù)至少12周，常伴有炎癥，可能與細菌感染有關(guān)，也可能無關(guān)。復(fù)發(fā)性鼻竇炎指一年內(nèi)發(fā)作四次或更多次，每次持續(xù)時間少于兩周。鼻竇炎通常由病毒、細菌或真菌引起。引起普通感冒的病毒是鼻竇炎最常見的病因。細菌既可能直接導(dǎo)致鼻竇炎，也可能在病毒性鼻竇炎后繼發(fā)感染。如果你的流鼻涕、鼻塞和面部疼痛癥狀持續(xù)超過10天仍未緩解，你就可能患有細菌性鼻竇炎。癥狀有時會暫時好轉(zhuǎn)，但隨后復(fù)發(fā)且比初始癥狀更嚴重?？股睾蜏p充血劑通常對細菌性鼻竇炎效果較好。由真菌引起的鼻竇感染通常比細菌性或病毒性鼻竇炎更為嚴重，更容易發(fā)生在免疫系統(tǒng)較弱的人群中。PassageTwoSnoring:AHealthAlarmNottoBeIgnoredHelloeveryone.Today,let’stalkaboutsnoring—aphenomenonthatseemsordinarybutactuallyhidespotentialhealthrisks.Manypeoplethinksnoringisjustaminorissuethatdisturbsothers’sleep,butinfact,itisoftenahealthalarmsentbythebody.Afterfallingasleep,themusclesinthethroatnaturallyrelax.Iftheairwaybecomesnarrowforvariousreasons,theairflowpassingthroughitcancausethesurroundingsofttissuestovibrate,producingthesoundofsnoring.Thisprocessissimilartohowawindinstrumentproducessoundwhenairvibratesitsreed.Studieshavefoundthatnearlyhalfofalladultsexperiencesomedegreeofsnoring.Amongthem,overweightindividualsaremorepronetoseveresnoringduetofataccumulationintheneckcompressingtheairway.Aspeopleage,decreasedmuscletonecanalsoworsenthiscondition.Inaddition,nasalstructuralabnormalities,long-termsmoking,alcoholconsumption,andimpropersleepingpositionscansignificantlyincreasethelikelihoodofsnoring.What’smoreconcerningisthatsnoringisoftenanearlysignofObstructiveSleepApneaSyndrome(OSAS).Patientswiththisconditionexperiencerepeatedpausesinbreathingduringsleep,eachlastingmorethan10seconds—sometimesuptoaminute.Theseepisodesofintermittentoxygendeprivationcausethebraintobriefly“wakeup”torestorebreathing.Althoughthepatientisoftenunawareofthis,itdisruptscontinuoussleepandseriouslyaffectssleepquality.Ifleftuntreated,long-termsnoringcanleadtoavarietyofhealthproblems.Thecardiovascularsystemisoftenthefirsttobeaffected—patientsfaceasignificantlyhigherriskofhypertension,coronaryheartdisease,andarrhythmias.Theendocrinesystemmayalsobeimpacted,asinsulinresistanceworsens,potentiallytriggeringoraggravatingdiabetes.Intermsofthenervoussystem,chronicoxygendeprivationcanleadtomemorydeclineandpoorconcentration,whileexcessivedaytimesleepinessgreatlyincreasestheriskoftrafficaccidents.Improvingsnoringrequiresacomprehensiveapproach.Lifestyleadjustmentsarefundamental—maintainingahealthyweight,quittingsmoking,limitingalcoholintake,andsleepingonone’ssideareallrecommended.Forthosewhosesnoringiscausedbynasalproblems,treatingtheunderlyingconditioncanoftenyieldgoodresults.Patientswithmoreseveresymptomsmayrequiremedicalintervention.ThemostwidelyrecognizedeffectivetreatmentisContinuousPositiveAirwayPressure(CPAP)therapy.Insomecases,oralappliancesorsurgerymayalsobenecessaryoptions.Ifyousnoreandexperiencebreathingpauses,frequentnighttimeawakenings,morningheadaches,orexcessivedaytimesleepiness,youshouldseekmedicalattentionpromptly.Patientswithchroni