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临床医学英语翻译 Chapter 1 Patient-Physician Interaction Page 1 第一章 医患沟通 第１页 The patient-physician interaction proceeds through many phases of clinical reasoning and decision making. proceed 进行、开展 reasoning 推论、推理 clinical reasoning 诊断 clinical decision 确定治疗方案 making decision 做出决定 医患沟通在临床诊断和治疗决策的许多阶段中进行着。 The interaction begins with an elucidation of complaints or concerns, followed by inquiries or evaluation to address these concerns in increasingly precise ways. elucidation 说明、阐明 inquire 询问、调查 evaluation 评估、评价 这种沟通开始于病人诉说或所关注问题，然后通过询问、评估不断精确地确定这些问题。 The process commonly requires a careful history or physical examination, ordering of diagnostic tests, integration of clinical findings with the test results, understanding of the risks and benefits of the possible courses of action, and careful consultation with the patient and family to develop future plans. integration 综合 consultation 磋商、会诊 这个过程通常需要细致的病史询问和体格检查，进行诊断性化验，综合临床发现和化验结果，理解分析拟行治疗过程中的风险和疗效，并与病人及家属反复磋商以形成治疗方案 Physicians increasingly can call on a growing literature of evidence-based medicine to guide the process so that benefit is maximized,　while respecting individual variations among different patients respecting 注意到、关系、说到 evidence-based medicine 循证医学 医生们越来越容易查阅不断增长的循证医学文献来指导这个过程，使得疗效最大化，但要考虑到不同病人中个体差异是存在的。 The increasing availability of randomized trials to guide the approach to diagnosis and therapy should not be equated with “cookbook” medicine availability　可利用性， 可得到 randomize 随机的 cookbook 食谱，烹调书 approach 接近 越来越多的可用于指导临床诊断与治疗的随机试验资料不应变成“烹调书”医学。 Evidence and the guidelines that are derived from it emphasize proven approaches for patients with specific characteristics. Evidence 证据，迹象 guideline　指导方针 emphasize 强调 因为随机试验获得的现象和思路是着重于特征性病人的求证过程。 Substantial clinical judgment is required to determine whether the evidence and guidelines apply to individual patients and to recognize the occasional. substantial clinical 真实的，实在的 individual 个体 occasional 偶尔的，特殊