医患英文对话 | 急性白血病
摘要: 急性白血病(Acute Leukemia)是一种起病急、进展快的血液系统恶性肿瘤,特征为骨髓中异常原始细胞大量增殖,抑制正常造血功能,常表现为贫血、出血、感染及器官浸润等症状。
- 急性白血病典型症状包括疲劳、头晕、发热、自发性瘀斑、鼻出血和骨痛。
- 诊断依赖血常规发现白细胞增多、血小板减少、贫血及外周血中出现原始细胞,并需通过骨髓检查确诊。
- 治疗以化疗为主,辅以抗生素、输血等支持疗法,早期住院干预至关重要。
- 医生在沟通中强调明确诊断的重要性,并列举了需鉴别的其他血液疾病如再生障碍性贫血、巨幼细胞性贫血等。
- 医患英文对话展示了从初诊问症到确诊建议的完整临床交流流程,适用于医学英语学习。
小白老师说:什么是奋斗?奋斗就是每一天都很难,可一年一年却越来越容易。不奋斗就是每天都很容易,可一年一年却越来越难。医患英文对话,今天的主题是 Acute Leukemia(急性白血病),音频是录的美音。
Acute Leukemia
Doctor: Sit down, please. What’s troubling you?
请坐,你哪儿不舒服?
Patient: I often have vertigoes, dizziness and fatigue.
我经常感到头晕,眼花和疲劳。
Doctor: How long have you been feeling like this?
有多长时间了?
Patient: About a month.
一个月左右。

Doctor: Did you have a fever?
你有发烧吗?
Patient: Yes, and I faint from time to time.
是的,而且经常头晕乏力。
Doctor: Well, let me take your temperature.
来,给你测一下体温。
Patient: Do I have a temperature, doctor?
医生,我有热度吗?
Doctor: Yes, a little, 37.5 ℃(thirty-seven point five degrees centigrade). Did your nose bleed?
有低热,37.5℃。你的鼻子有流过血吗?
Patient: Yes, it bleeds sometimes, but it didn’t bleed much.
有时流血,但量不多。
Doctor: Do you often have bruises on your limbs?
你的四肢经常有紫斑吗?
Patient: Yes, I do.
是的,常有。
Doctor: Do the bruises occur spontaneously or after trauma?
这些紫斑是自发出现的还是受伤后出现的?
Patient: They appear spontaneously.
是自发的。

Doctor: Do you feel a pain in your bone?
你感到骨痛吗?
Patient: Yes, I have a pain in my sternum when I press it hard.
是的,当我用力压胸骨时有疼痛。
Doctor: You’d better have a blood test, the laboratory is on the second floor.
你需要检查血象, 化验室在二楼。
Patient: What’s the result, doctor?
医生,化验结果怎么样?
Doctor: The laboratory report is not so good. It showed leukocytosis, thrombocytopenia and anemia. There are some blast cells in the peripheral blood. I think you have to take bone marrow examination.
血象报告的结果不太好,白细胞计数增高,血小板减少,且有贫血,周围血中发现幼稚细胞。我看你得做骨髓象检查。

Patient: Does the bone marrow examination have any complication?
骨髓象检查有合并症吗?
Doctor: It is safe and no complication. It should help the diagnosis of diseases.
这种检查很安全,无合并症,它有助于疾病的诊断。
Patient: Is my condition serious, doctor?
医生,我的病严重吗?
Doctor: Don’t worry about that. A variety of diseases can cause anemia or thrombocytopenia, such as aplastic anemia, acute leukemia, macrocytic anemia, paroxysmal nocturnal hemoglobinuria and so on. You should be treated soon when the diagnosis is clear.
别担心,有很多疾病可以出现贫血或血小板减少,如再生障碍性贫血、急性白血病、巨幼细胞性贫血、阵发性睡眠性血红蛋白尿等。把诊断搞清楚后,马上给你治病。
Patient: Would you tell me what trouble do I suffer from, doctor?
医生,你能告诉我患了什么病吗?
Doctor: According to the symptoms and laboratory findings, your disease may be diagnosed as acute leukemia.
根据症状和实验室检查结果,你患了急性白血病。
Patient: Oh! Dear! I know it is a serious disease.
噢!我知道这是一种严重的疾病!
Doctor: You should be admitted to hospital immediately.
你应该立即住院治疗。

Patient: Can acute leukemia be cured, doctor?
医生,急性白血病能治好吗?
Doctor: We’re determined to try our best to cure you.
我们一定尽力想办法来治疗。
Patient: What method should I be treated with?
用什么方法为我治疗?
Doctor: The chemotherapy should be used for you. Another assistant therapy is administered as well, including antibiotics and blood transfusion.
我们将给你使用化学疗法,其他的辅助疗法如抗菌药物和输血也要使用。
Patient: Is there anything I should or shouldn’t do?
对我的病还有什么限制吗?
Doctor: I advise you to take a good rest. I really hope you’ll recover soon. You could call at the in-patient department tomorrow.
你要好好休息,我希望你快点好起来。明天你到住院部来。
Patient: Thank you for your advice. I’ll come to hospital tomorrow, doctor. Good-bye!
医生,非常感谢您的建议。明天我就来住院。再见!
常见问题
急性白血病有哪些常见症状?
常见症状包括持续疲劳、头晕、低热、自发性皮肤瘀斑、鼻出血、胸骨压痛以及反复感染等。
如何诊断急性白血病?
初步通过血常规发现异常(如白细胞升高、血小板减少、贫血及原始细胞),确诊需进行骨髓穿刺和骨髓象检查。
骨髓检查安全吗?
骨髓检查是一种安全的常规操作,通常无严重并发症,对明确血液病诊断至关重要。
急性白血病能治愈吗?
虽然病情严重,但通过及时化疗和支持治疗,部分患者可获得缓解甚至长期生存,治疗效果与分型、年龄及响应情况相关。
参考资料
急性白血病诊疗指南(中国)
中华医学会血液学分会发布,用于规范急性白血病的诊断与治疗流程。
UpToDate: Acute Leukemia in Adults
权威临床决策支持资源,涵盖急性白血病的临床表现、诊断标准与治疗策略。