【醫(yī)學(xué)口語會(huì)話】暈厥

　　patient ： Doctor I have been suffering from " fits" for a few years . I wonder what matter is with me and hope you'll 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： What time did your attack begin?

　　P： 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： How long is the interval between two successive attacks?

　　P： Sometimes round a month ， and sometimes two months . Could it be related to circumstances?

　　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 couldn't control myself. I screamed and blacked out .

　　D： Were you injured?

　　P： No ， the car stopped at once . 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 that 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 county's hospital told me that my physical examination ， electr ocardiogram ， and chest and skull x-ray examination results were normal . I've 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 sheets . 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 examinations 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 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 regulating your life such as getting up and going to bed regularly and not drinking or smoking too much . I'll give you some medicine to regulate the function of your autonomic nervous system . If you follow my advice， I'm sure your condition will get better soon. Sometimes your symptoms may recur ， this is a natural phenomenon . Don't worry ， such recurrences don't mean regression . During the struggle against disase ， you must feel confident that you can overcome it ， then the medicine， which I'll give you ， will help you defeat the enemy-syncope . Medicine is one way ， confidence is another . The latter is more important than the former . You must keep my words in your mind .

　　P： Thanks a lot ， doctor.

　　病人：醫(yī)生，近幾年來我常常"突然發(fā)作".我真想知道我得了什么病，希望您快些給治好。

　　醫(yī)生：您說的"突然發(fā)作"是什么意思?

　　病人：我所說的"突然發(fā)作"是指我突然不醒人事，摔倒地上。

　　醫(yī)生：您的發(fā)作是什么時(shí)候開始的?

　　病人：在我結(jié)婚時(shí)，當(dāng)時(shí)我才25歲。

　　醫(yī)生：至今有多少年了?

　　病人：3年多了。

　　醫(yī)生：每次犯病持續(xù)多長時(shí)間?

　　病人：大約1分鐘。

　　醫(yī)生：每次發(fā)作相隔多久?

　　病人：有時(shí)候約1個(gè)月，有時(shí)2個(gè)月左右。我的病發(fā)作與周圍環(huán)境有關(guān)系嗎?

　　醫(yī)生：平常在什么情況容易引起您的病發(fā)作?

　　病人：很難說清楚。有一次我過馬路時(shí)，忽然一輛小轎車飛快地向我開來，當(dāng)時(shí)我十分緊張，控制不住自己了。我大叫一聲就什么也不知道了。

　　醫(yī)生：您傷著了嗎?

　　病人：沒有，汽車馬上停下來了。我很快醒過來就回家了。

　　醫(yī)生：還怎樣發(fā)作過?

　　病人：另一次，我看一位護(hù)士給別的病人抽血，就冒汗、發(fā)軟，隨后就暈過去了。

　　醫(yī)生：在發(fā)病的時(shí)候還有什么其他的表現(xiàn)嗎?

　　病人：據(jù)看到我發(fā)病的人說，在我發(fā)作時(shí)，臉色蒼白，大量出汗，但是沒有摔搐、大小便失禁或其他情況。

　　醫(yī)生：您做過專門的檢查嗎?

　　病人：我們縣醫(yī)院的醫(yī)生對(duì)我說過，我的體格檢查、心電圖、胸部和頭顱的 X線檢查都正常。其他的專門檢查就沒有做過了。

　　醫(yī)生：我給您做一個(gè)內(nèi)科和神經(jīng)科的全面檢查吧。您還需要做些進(jìn)一步檢查，包括腦電圖和腦掃描。心電圖也再做一個(gè)。這是各項(xiàng)檢查單，把所有的檢查做完后再來門診看病。

　　病人：您讓我做的都做完了。結(jié)果都出來嗎?

　　醫(yī)生：結(jié)果出來了，結(jié)果都正常。

　　病人：那我的"突然發(fā)作"是怎么回事?

　　醫(yī)生：根據(jù)內(nèi)科、神經(jīng)科以及一些其他專門檢查看來，您既不是器質(zhì)性的心臟病或顱腦病，也不是顛癇。您突然發(fā)作時(shí)的病狀和體征，如心跳、蒼白和過多的血汗等，跟您自主神經(jīng)系統(tǒng)功能失調(diào)是相符的。自主神經(jīng)系統(tǒng)的功能失調(diào)能引起心博出量的減少、腦貧血、大腦功能抑制，最后失去知覺。象這樣的病我們就稱做暈厥。

　　病人：您能用什么藥治療我的暈厥嗎?

　　醫(yī)生：您要注意的是生活要有規(guī)律，比如按時(shí)起床，睡覺，不要過多地抽煙和喝酒。我給您開點(diǎn)調(diào)節(jié)您的自主神經(jīng)功能的藥。如您能聽從我的勸告，我相信您一定會(huì)很快好起來的。一些癥狀有時(shí)可能有反復(fù)，這是常有的事情。不過，不要緊。這并不說明病情惡化。當(dāng)你和疾病做斗爭時(shí)，必須樹立能克服的它的信心，另外，我再給您開些藥，會(huì)治好您這是暈厥病的。藥是一方面，信心和精神又是一方面，后者比前者更重要。您一定要記住我的話。

　　病人：多謝了，醫(yī)生。