医患英文对话精听 | 眩晕 Vertigo
摘要： 眩晕（Vertigo）是一种患者感到自身或周围环境旋转、晃动的错觉，常伴随恶心、呕吐、头痛及听力异常等症状。在医患英文对话中，医生通过系统问诊了解发作频率、持续时间、诱发因素及相关病史，以辅助鉴别诊断。本例患者为59岁女性，有糖尿病和胆囊切除史，并伴有耳鸣、头痛及日间发作性眩晕。
- 眩晕患者常描述房间旋转、站立不稳，严重时不敢移动身体。
- 医生需详细询问眩晕发作的时间模式、持续时长、伴随症状（如耳鸣、头痛）及可能诱因。
- 该患者日间发作、无体位诱发、伴双侧耳鸣和跳痛性头痛，提示需考虑前庭性偏头痛或梅尼埃病等鉴别诊断。
- 既往病史包括糖尿病、胆囊切除术及9年前性病治疗史，对全面评估具参考价值。
- 医患英文对话中包含多个临床高频表达，如‘bring anything up’（咳出痰液）、‘buzzing or ringing noises’（耳鸣）等，适用于医学英语学习与考试准备。
小白老师说：今天医患对话精听的主题是眩晕 Vertigo，患者是患有糖尿病，做过胆囊切除。可能的生词我已经给大家注好了中文。很多实用的句型值得模仿。参加医博英语考试的童鞋们可以好好琢磨一下这个长对话有哪些可能的考点。OK，请点击下方条形框播放语音。
WOMAN, AGED59 (女性， 59岁）
（D=Doctor, P=Patient）
D: I see you have had several attacks of influenza. Anything else?
P: I’ve had dizziness and I’ve been sick.
D: When did this start?
P: Two months ago.
D: How often are the attacks?
P: Nearly every day.
D: How long do they last?
P: Some last all day, some a couple of hours.
D: Does anything bring on these attacks?
P: No.
D: Will you describe one of these attacks?
P: It starts with a headache—a throbbing headache(一阵一阵的跳痛). My eyes start running（眼睛开始流泪）. I cannot touch them, they are so sore. And then the whole house goes around. Then it goes dark.
D: Do you see flashing lights?
P: No.
D: When you say you go dizzy, what do you mean?
P: I feel I’ll fall over and the room spins round. If I go to bed, the bed goes round.
D: When you move, do you stagger?
P: I’m too scared to move.
D: Have you noticed anything else?
P: I cough a lot.
D: Do you bring anything up?（有没有痰？）
P: No.
D: Is your hearing affected? Do you have buzzing or ringing noises?（听到嗡嗡声或钟鸣声了吗？）
P: Yes.
D: In both ears?
P: Yes.
D: When you go to bed, do you sleep?
P: I just lie and it goes off within a few hours.
D: Have you ever woken up like this?
P: No. It is always in the day.
D: Does movement of the head cause it?
P: No.
D: If you suddenly get up out of a chair does it start?
P: No.
D: How long have you been diabetic?
P: Four years.
D: Any other serious illness?
P: I had my gall bladder removed. （我做过胆囊切除术）
D: Anything else?
P: I had VD nine years ago（9年前得过性病）. I was in hospital for three weeks and had a course of injections（注射一个疗程）.
常见问题
眩晕和普通头晕有什么区别？
眩晕特指感到自身或环境旋转、晃动，常伴恶心、平衡障碍；而普通头晕多为头重脚轻、昏沉感，无旋转错觉。
医生为什么询问耳鸣和听力变化？
因为内耳是平衡与听觉的重要器官，耳鸣或听力下降可能提示梅尼埃病、前庭神经炎等内耳疾病。
糖尿病会影响眩晕吗？
糖尿病可能通过影响血管或神经功能间接导致眩晕，但通常不是直接病因，需结合其他症状综合判断。
‘I had VD nine years ago’中的VD是什么意思？
VD是venereal disease（性传播疾病）的旧称，现多用STI（sexually transmitted infection），此处指患者曾患性病并接受注射治疗。
参考资料
Vertigo: Diagnosis and Management
UpToDate 或 BMJ Best Practice 等临床指南可作为眩晕诊疗依据，但原文未引用具体文献。
医博英语考试常见医患对话场景
内容适用于中国医学博士英语考试（医博英语）听力与口语备考。