基礎(chǔ)醫(yī)學(xué)英語譯文.doc

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第七單元 Text A 成人尿路感染 尿路感染是一個嚴重的健康問題，每年影響數(shù)百萬人。 泌尿道Infections of the urinary tract are the second most common type of infection in the body.感染是人體第二大最常見類型的感染。每年因Urinary tract infections (UTIs) account for about 8.3 million doctor visits each year.* Women are especially prone to UTIs for reasons that are not yet well understood.尿路感染（UTIs ）就醫(yī)的人數(shù)約為830萬人。婦女尤其容易感染UTIs，但原因尚不清楚。20％的女性會患尿路感染20會感染會患尿路感染 會。UTIs in men are not as common as in women but can be very serious when they do occ男子的發(fā)病率不如女性高，但一旦發(fā)病會很嚴重。 * Ambulatory Care Visits to Physician Offices, Hospital Outpatient Departments, and Emergency Departments: United States, 1999–2000. Vital and Health StatisticsThe urinary system consists of the kidneys, ureters, bladder, and urethra.泌尿系統(tǒng)由腎臟﹑輸尿管﹑膀胱和尿道組成。系統(tǒng)中The key elements in the system are the kidneys, a pair of purplish-brown organs located below the ribs toward the middle of the back.關(guān)鍵要素是腎臟，位于背部中間肋骨下方的一對深紫色器官。 The kidneys remove excess liquid and wastes from the blood in the form of urine, keep a stable balance of salts and other substances in the blood, and produce a hormone that aids the formation of red blood cells.腎臟以尿液的形式消除血液中過剩的液體和廢物，保持血液中鹽和其它物質(zhì)相對的穩(wěn)定和平衡，產(chǎn)生促使紅血球生成的激素。稱為Narrow tubes called ureters carry urine from the kidneys to the bladder, a sack-like organ in the lower abdomen.輸尿管的窄管把尿液從腎臟導(dǎo)到膀胱，一個位于下腹袋子狀的器官。 Urine is stored in the bladder and emptied through the urethra.尿液儲存在膀胱里并通過尿道排空。 The average adult passes about a quart and a half of urine each day.成人平均每天排尿量為1.5夸脫（大約1500毫升）。 但尿量不盡相同The amount of urine varies, depending on the fluids and foods a person consumes.但尿量，這取決于人消耗的食物和水。 The volume formed at night is about half that formed in the daytim夜間形成的尿量只有白天的一半左右。 [ Top ] What are the causes of UTI?尿路感染的原因 Normally, urine is sterile.尿液通常是無菌的，一般不含細菌、病毒和真菌，但含有液體、鹽和廢物。 有An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply.有有有些微生物，通常是從消化道進入的細菌，聚集在尿道，并開始繁殖，就會引發(fā)感染。 The urethra is the tube that carries urine from the bladder to outside the body.尿道是將尿液從膀胱排除體外的管道。 Most infections arise from one type of bacteria, Escherichia coli (E. coli), which normally lives in the colon.大部分感染是由大腸桿菌引起的，通常生活在結(jié)腸。 In many cases, bacteria first travel to the urethra.通常情況下，細菌首先進入尿道。 When bacteria multiply, an infection can occur.當細菌繁殖，感染就可能發(fā)生。 如果An infection limited to the urethra is called urethritis.感染只限于尿道，就是尿道炎。 If bacteria move to the bladder and multiply, a bladder infection, called cystitis, results.如果細菌轉(zhuǎn)移到膀胱并且繁殖，引起膀胱感染，則是膀胱炎。 If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys.如果感染不及時治療，細菌可能進一步進入輸尿管繁殖導(dǎo)致腎臟感染。 A kidney infection is called pyelonephritis.腎臟感染是所謂的腎盂腎炎。 稱為Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in both men and women, but these infections tend to remain limited to the urethra and reproductive system.衣原體和支原體的微生物也可能導(dǎo)致男性和婦女的尿路感染，但這些感染往往只限于尿道和生殖系統(tǒng)。 與欲與大腸桿菌不同， 衣原體和支原體可通過性傳播。 The urinary system is structured in a way that helps ward off infection.泌尿系統(tǒng)的結(jié)構(gòu)有助于抵御感染。 The ureters and bladder normally prevent urine from backing up toward the kidneys, and the flow of urine from the bladder helps wash bacteria out of the body.輸尿管和膀胱，防止尿液回流到腎臟而且從膀胱流出的尿液有助于清除體內(nèi)的細菌。 In men, the prostate gland produces secretions that slow bacterial growth.男性的前列腺產(chǎn)生的分泌物使細菌生長緩慢；In both sexes, immune defenses also prevent infection.男性和男性和女性的免疫系統(tǒng)都可以防止感染。 But despite these safeguards, infections still occur.盡管如此，感染仍會發(fā)生。 Who is at risk?危險人群 Some people are more prone to getting a UTI than others.有些人比其他人更容易得尿路感染。 Any abnormality of the urinary tract that obstructs the flow of urine (a kidney stone, for example) sets the stage for an infection.任何阻礙尿液流動的尿道異常（例如，腎結(jié)石）都有可能誘發(fā)感染。 An enlarged prostate gland also can slow the flow of urine, thus raising the risk of infection.前列腺肥大也可以使尿液流動緩慢，增大感染風(fēng)險。 常見的感染源是置放于尿道和膀胱里的導(dǎo)尿管。不能排尿的或病情嚴重而喪失一時的患者，常長期需要插導(dǎo)尿管。A common source of infection is catheters, or tubes, placed in the urethra and bladder.Some people, especially the elderly or those with nervous system disorders who lose bladder control, may need a catheter for life.有些人，特別是老人或那些因神經(jīng)系統(tǒng)疾病導(dǎo)致膀胱功能失控的病人，可能終生要靠插導(dǎo)管生活。 Bacteria on the catheter can infect the bladder, so hospital staff take special care to keep the catheter clean and remove it as soon as possible.導(dǎo)尿管上的細菌可能感染膀胱，因此醫(yī)務(wù)人員均特別注意保持導(dǎo)管清潔并盡早拔掉尿?qū)Ч堋? 因為免疫系統(tǒng)的變化，People with diabetes have a higher risk of a UTI because of changes in the immune system.糖尿病患者得尿路感染的風(fēng)險較高。 Any other disorder that suppresses the immune system raises the risk of a urinary infection.任何其它抑制免疫系統(tǒng)的病變都會加劇這種風(fēng)險。 先天性尿道異常的UTIs may occur in infants, both boys and girls, who are born with abnormalities of the urinary tract, which sometimes need to be corrected with surgery.嬰兒，不分性別，也會患尿路感染，有時需要手術(shù)。 UTIs are more rare in boys and young men.尿路感染在男孩和青年男子中較罕見。 但是In adult women, though, the rate of UTIs gradually increases with age.在成年婦女中，尿路感染發(fā)病率逐漸隨著年齡增長。 Scientists are not sure why women have more urinary infections than men.科學(xué)家尚不明確為什么婦女患泌尿系感染多于男性。 One factor may be that a womans urethra is short, allowing bacteria quick access to the bladder.其中一個因素可能是女性尿道短，使細菌快速進入膀胱。 Also, a womans urethral opening is near sources of bacteria from the anus and vagina.此外，女性的尿道口離肛門和陰道的細菌源很近。 For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.對許多婦女，性交可能引發(fā)感染，雖然這種情況的原因尚不明確。 According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control.研究表明，使用子宮帽節(jié)育的婦女比采用其它措施節(jié)制生育的女性更容易得尿道炎。 Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E.最近，研究人員發(fā)現(xiàn)，配偶使用保險套與殺精泡沫也往往coli bacteria in the vagina.使大腸桿菌進入女性陰道。 What are the symptoms of UTI?尿路感染的癥狀 Not everyone with a UTI has symptoms, but most people get at least some symptoms.不是每個患有尿路感染的人都有癥狀，但大部分人至少有某些癥狀，尿頻或排尿時膀胱或尿道灼痛。It is not unusual to feel bad all over—tired, shaky, washed out—and to feel pain even when not urinating.人們往往感覺疲倦、虛弱、面色蒼白，甚至在不排尿時也覺得疼痛，也是常見情況。 Often women feel an uncomfortable pressure above the pubic bone, and some men experience a fullness in the rectum.婦女往往覺得恥骨部位不舒服的壓迫感，有些男人覺得直腸漲氣。有尿路It is common for a person with a urinary infection to complain that, despite the urge to urinate, only a small amount of urine is passed.患有患有尿路尿路感染患者主訴，盡管有排尿感，只有少量的尿液排出。The urine itself may look milky or cloudy, even reddish if blood is present.尿液混濁狀，甚至血尿。Normally, a UTI does not cause fever if it is in the bladder or urethra.通常，膀胱或尿道感染不會引起發(fā)燒。 A fever may mean that the infection has reached the kidneys.發(fā)燒可能意味著感染已達到了腎臟。Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.腎臟感染的其它癥狀包括背部或肋骨側(cè)下方疼痛、惡心或嘔吐等。 In children, symptoms of a urinary infection may be overlooked or attributed to another disorder.兒童尿路感染的癥狀可能被忽略或歸咎于其它疾病。當兒童或嬰兒急躁、食欲不振、原因不明的發(fā)熱而且持續(xù)不退、腹瀉、萎靡不振，應(yīng)考慮患有尿路感染。與Unlike adults, children are more likely to have fever and no other symptom成人不同，兒童更有可能發(fā)燒而且沒有其它癥狀。 This can happen to both boys and girls.男孩和女孩都有可能如此。 如果孩子出現(xiàn)這些癥狀，尤其是尿出現(xiàn)變化，應(yīng)及時就醫(yī)The child should be seen by a doctor if there are any questions about these symptoms, especially a change in the childs urinary pattern.如果。 How is UTI diagnosed?尿路感染如何診斷？ To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria.要了解是否患有尿路感染，醫(yī)生將提取尿液樣本測試尿膿和細菌。 You will be asked to give a "clean catch" urine sample by washing the genital area and collecting a "midstream" sample of urine in a sterile container.您要清洗外陰以便提交一個“干凈”的尿液樣本并把收集的尿液樣本裝在無菌容器里。This method of collecting urine helps prevent bacteria around the genital area from getting into the sample and confusing the test results.這種方法收集尿液，有助于防止生殖器官周圍的細菌進入樣本而影響檢測結(jié)果。Usually, the sample is sent to a laboratory, although some doctors offices are equipped to do the testing.雖然有些醫(yī)生辦公室都配備做這樣測試的儀器，但通常情況下，樣本要送實驗室。 In the urinalysis test, the urine is examined for white and red blood cells and bacteria.尿液檢驗檢查尿液中白細胞、紅細胞和細菌。Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria.然后進行細菌培養(yǎng)，用不同的抗生素做對抗實驗，看看哪種藥物能最有效地殺死細菌。This last step is called a sensitivity test.這最后一步就是藥效敏感性試驗。 Some microbes, like Chlamydia and Mycoplasma , can be detected only with special bacterial cultures.一些微生物，如衣原體和支原體，只有通過特殊的細菌培養(yǎng)才可檢測到。當患者有UIT癥狀液中有尿路感染，醫(yī)生會懷疑是患有尿路感染的一種。但普通的細菌培養(yǎng)不能發(fā)現(xiàn)任何細菌。 如果When an infection does not clear up with treatment and is traced to the same strain of bacteria, the doctor may order some tests to determine if your system is normal.如果如果感染沒有因治療消除，而且發(fā)現(xiàn)感染由同一菌株的細菌引起的，醫(yī)生可能會要求做一些檢測，以確定患者的系統(tǒng)是否是正常。One of these tests is an intravenous pyelogram, which gives x-ray images of the bladder, kidneys, and ureters.這些測試之一就是靜脈腎盂造影，通過X射線照出膀胱、腎臟和輸尿管的圖像。將注入靜脈，拍下一組X光照片An opaque dye visible on x-ray film is injected into a vein, and a series of x rays is taken. XX。照照片展現(xiàn)了泌尿道的輪廓，即使是很小的變化也能檢測出來。 If you have recurrent infections, your doctor also may recommend an ultrasound exam, which gives pictures from the echo patterns of soundwaves bounced back from internal organs.如果經(jīng)常感染，醫(yī)生會推薦超聲波檢驗，通過內(nèi)部器官反彈超聲波的回聲成像。 Another useful test is cystoscopy.另一種有效的測試是膀胱鏡檢查。A cystoscope is an instrument made of a hollow tube with several lenses and a light source, which allows the doctor to see inside the bladder from the urethra膀胱鏡是一種由空心管﹑幾個鏡片和光源組成的器械，使醫(yī)生可從尿道檢查膀胱。 How is UTI treated?尿路感染的治療 UTIs are treated with antibacterial drugs.抗菌藥物可治療尿路感染?；颊卟∈泛湍驒z結(jié)果決定用藥種類和治療期限。 The sensitivity test is especially useful in helping the doctor select the most effective drug.敏感性測試在幫助醫(yī)生選擇最有效的藥物方面是特別有用的。 The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprim/sulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin).最常用于治療常規(guī)感染的藥物是甲氧芐氨嘧啶（ trimpex ） 、甲氧芐啶/磺胺甲基異惡唑（ bactrim ， septra ，科特林）、阿莫西林（ amoxil ， trimox ， wymox ）、呋喃妥因（ macrodantin ，呋喃坦啶）和氨芐西林（ omnipen ， polycillin ， principen ， totacillin ）。 A class of drugs called quinolones includes four drugs approved in recent years for treating UTI.喹諾酮類藥物，即四種在近年來獲得批準用于治療尿路感染藥物是它們是氧氟沙星（ floxin ）、諾氟沙星（ noroxin ）、環(huán)丙沙星（ cipro ）和曲伐沙星（ trovan ）。 通常情況下，如果沒有并發(fā)阻塞或其它疾病，Often, a UTI can be cured with 1 or 2 days of treatment if the infection is not complicated by an obstruction or other disorder.通通常尿路感染 1或2天的治療就可以治愈。Still, many doctors ask their patients to take antibiotics for a week or two to ensure that the infection has been cured.但是，許多醫(yī)生要求病人服用抗生素一至兩周時間，以確保治愈。Single-dose treatment is not recommended for some groups of patients, for example, those who have delayed treatment or have signs of a kidney infection, patients with diabetes or structural abnormalities, or men who have prostate infections.單劑量治療不適宜用于某些患者群體，例如延誤治療或有腎臟感染跡象的患者、有糖尿病的患者或結(jié)構(gòu)異常的病人、或有前列腺炎的男性。Longer treatment is also needed by patients with infections caused by Mycoplasma or Chlamydia , which are usually treated with tetracycline, trimethoprim/sulfamethoxazole (TMP/SMZ), or doxycyclin由支原體、衣原體感染的患者需要更長時間的治療，常用藥物是四環(huán)素、甲氧芐啶/磺胺甲基異惡唑（TMP/SMZ）或強力霉素。隨訪尿檢隨訪尿檢幫助確認尿路感染是否治愈。療程完整很重要，因為癥狀可能會在感染完全清除之前消失。 嚴重的Severely ill patients with kidney infections may be hospitalized until they can take fluids and needed drugs on their own.腎臟感染患者需要住院，直至消除水腫并可獨立服藥。Kidney infections generally require several weeks of antibiotic treatment.腎臟感染通常需要幾個星期抗生素治療。Researchers at the University of Washington found that 2-week therapy with TMP/SMZ was as effective as 6 weeks of treatment with the same drug in women with kidney infections that did not involve an obstruction or nervous system disorder.華盛頓大學(xué)的研究人員發(fā)現(xiàn)， 服用甲氧芐啶/磺胺甲基異惡唑療法2周與6周治療女性腦梗塞或中樞神經(jīng)系統(tǒng)紊亂的腎臟感染是一樣有效的。In such cases, kidney infections rarely lead to kidney damage or kidney failure unless they go untreated.在這種情況下，腎臟感染很少導(dǎo)致腎損害或腎功能衰竭，除非未經(jīng)任何治療。 Various drugs are available to relieve the pain of a UTI.緩解尿路感染疼痛的藥物有很多。 A heating pad may also help.加熱墊也有作用。Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria.大部分醫(yī)生建議多喝水，以利于清潔尿路中的細菌。治療期間，最好不喝咖啡﹑酒﹑忌辛辣食物。And one of the best things a smoker can do for his or her bladder is to quit smoking.吸煙者要戒煙以保護膀胱。眾所周知，Smoking is the major known cause of bladder cancer.吸煙是誘發(fā)膀胱癌的主要原因。 Is there a vaccine to prevent recurrent UTIs?有疫苗可預(yù)防尿路感染？ In the future, scientists may develop a vaccine that can prevent UTIs from coming back.將來，科學(xué)家可能發(fā)明一種可以防止尿路感染復(fù)發(fā)的疫苗。 Researchers in different studies have found that children and women who tend to get UTIs repeatedly are likely to lack proteins called immunoglobulins, which fight infection.研究人員在不同的研究中發(fā)現(xiàn)，反復(fù)得尿路感染的婦女和兒童往往缺乏能對抗感染的一種蛋白質(zhì)，即免疫球蛋白。不不感染的婦女和兒童的生殖器官和泌尿道有正常水平的免疫球蛋白。 Early tests indicate that a vaccine helps patients build up their own natural infection-fighting powers.早期試驗表明，疫苗可以幫助病人建立自身對抗感染能力。在免疫過程中死亡的細菌不會引起感染;相反，會迅速使身體產(chǎn)生抗體，對抗存活的細菌。 Researchers are testing injected and oral vaccines to see which works best.研究人員正在測試注射和口服疫苗，看看哪種最好。 Another method being considered for women is to apply the vaccine directly as a suppository in the vagina.另一種正在考慮對適用于婦女的方法是將疫苗栓劑直接作用在陰道。