加载中…
个人资料
月亮飞船
月亮飞船
  • 博客等级:
  • 博客积分:0
  • 博客访问:556,553
  • 关注人气:189
  • 获赠金笔:0支
  • 赠出金笔:0支
  • 荣誉徽章:
相关博文
推荐博文
谁看过这篇博文
加载中…
正文 字体大小:

孩子为何如此无精打采?(一)

(2009-12-21 11:32:46)
标签:

胡德良

mark

cohen

哮喘

黄疸

缺铁

贫血

牛奶

育儿

分类: 医疗卫生

Why Has the Baby Become So Listless1

By Mark Cohen     胡德良

I scanned the patient’s chart: “14-month-old boy with a cold, not eating.” The child’s father, a brown-skinned man in his forties, held his son in his lap. The baby was listless, his skin a pale yellowish-white. Jaundice1 was my first suspicion.  

 我浏览了一下病人的病历表:“14个月,男孩,患有感冒,厌食。”孩子的父亲是个棕色皮肤的男人,40多岁,搂着大腿上的孩子。孩子无精打采,皮肤苍白而微微发黄。我首先怀疑孩子得了黄疸。

 After introducing myself, I asked the father, “Does your son have any medical problems?”

 自我介绍后,我问这位父亲:“您儿子有大病吗?”

 He answered slowly, with the accent of his native Philippines: “My son has asthma2.”

 他操着菲律宾本土的口音慢腾腾地回答说:“我儿子患有哮喘。”

 Asthma does not cause jaundice. The boy’s lips were pale, almost gray, with no pink color at all. His fingernails, too, were so pale they looked almost chalky. Normally, his skin color would have been much like his father’s, a rich, light yellowish-brown, but all the red and pink tones had vanished. This baby was probably severely anemic3, which meant he was low in oxygen-carrying red blood cells. But asthma doesn’t give you anemia either.

 哮喘不会引起黄疸。孩子的嘴唇苍白中透着灰暗,没有一点血色。他的手指甲也是惨白惨白的,活像白垩一般。正常情况下,他的皮肤本该像他父亲的一样,呈现一种鲜亮的棕黄色,然而,所有的血红色调已全部消失。该婴儿很可能患有严重的贫血症,这说明他的携氧红细胞含量低。但是哮喘也不会导致贫血。

 The baby was breathing somewhat rapidly, and I heard a few wheezes4, but I saw no sign of a breathing obstruction. The boy gazed at me, slumped5 in his father’s lap, hardly moving.

 这个婴儿呼吸有些急促,我还听到几次艰难的呼吸,但我并没有观察到呼吸障碍物的迹象。他萎靡不振地呆在父亲的大腿上,一动不动。

 When I checked the computer for his medical records, the most recent entry gave me a jolt. Four months ago, he was admitted to the hospital with the diagnosis “asthma with acute respiratory6 failure”—a serious and sometimes fatal condition. Fortunately, the boy had recovered fairly quickly.

 我从计算机上调出他的病历记录,最近的一条记录吓了我一跳:四个月前他被医院收治,诊断为“哮喘伴有急性呼吸衰竭”——一种严重的病症,有时会导致死亡。幸运的是,这个孩子恢复得相当快。

 I listened to his lungs again. Although they didn’t sound bad, I called to the nurse: “Let’s check his oxygen. Give him oxygen if he needs it, and let’s also give him an albuterol7 breathing treatment.”

 我又听了听他的肺部。虽然他的肺听起来并不坏,但我还是向护士吩咐道:“咱们检查一下他的氧气供应情况吧,如需要,就给他输氧,同时还可以利用沙丁胺醇雾化吸入治疗。”

 I wasn’t going to take a chance. Although the boy’s asthma seemed mild, I would treat it aggressively, hoping to head off8 a severe episode. Still, I wondered, why was he so pale?

 我不打算冒险。虽然孩子的哮喘看来是轻微的,但是我仍想予以积极的治疗,以期避免严重的情况发生。尽管如此,我仍然纳闷:他为什么如此苍白?

 The only medication he was taking was for his asthma. The father added that the boy had been pale and lethargic9 for the last two or three months. He had not been eating—only drinking milk. He no longer babbled10, and he had lost interest in crawling or walking.

 他仅仅服用了治哮喘的药物。这位父亲又说孩子在过去的两三个月中肤色苍白而昏昏欲睡,一直不吃饭——只喝牛奶,他不再咿呀学语,对爬行和步行也失去了兴趣。

 Was some progressive disorder causing anemia and affecting his brain? Leukemia11 could do that, as could some other rare disorders. I examined the boy for signs of leukemia or another malignancy12, like an enlarged spleen13, swollen lymph nodes14, or signs of bleeding in the skin. Fortunately, I saw no warning signs. I also checked to see if the anemia had progressed to the point that his blood no longer carried enough oxygen for his body’s needs. His heart and lungs were working hard, but he didn’t seem in immediate danger.

 是否某种进行性疾病引起了贫血并影响到他的大脑?白血病及其他一些罕见疾病都会造成这种情况。我检查了这个男孩,看看有无患白血病或其他恶性疾病的征兆,象:脾肿大、淋巴腺肿胀或皮肤出血等现象。幸运的是并没有发现预兆病征。我又对他进行了检查以便确定他的贫血症是否已经恶化到这种地步—自身的血液不能携带足够的氧以供身体所需。尽管他的心脏和肺脏在吃力地工作着,但是看来他不会马上就有危险。

(待续)

Notes注释:

1.黄疸。

2.哮喘。

3.贫血的

4.wheeze喘息,艰难的呼吸。

5.意志消沉的,精神萎靡的。

6.呼吸的。

7.沙丁胺醇,舒喘灵。

8.阻止,防止。

9.昏睡的,瞌睡的。

10.            babble咿呀学语。

11.            白血病。

12.            恶性肿瘤,恶性疾病。

13.            脾。

14.            淋巴腺,淋巴结。

From: DISCOVER Vol. 27 No. 07 | July 2006 | Medicine

欢迎光临我博:http://blog.sina.com.cn/hudeliang158

 

0

阅读 评论 收藏 转载 喜欢 打印举报/Report
  • 评论加载中,请稍候...
发评论

    发评论

    以上网友发言只代表其个人观点,不代表新浪网的观点或立场。

      

    新浪BLOG意见反馈留言板 电话:4000520066 提示音后按1键(按当地市话标准计费) 欢迎批评指正

    新浪简介 | About Sina | 广告服务 | 联系我们 | 招聘信息 | 网站律师 | SINA English | 会员注册 | 产品答疑

    新浪公司 版权所有