5 Admission Orders 住院醫囑單 『誰下的、何時寫的』要可以看出來DiagnosisPerforated peptic ulcer with sepsisUncontrolled DMOld CVA with right hemiplegiaHypertensionAllergyShrimps (urticaria); penicillin (positive skin test或urticaria或probable anaphylactic shock)ConditionCritical or guarded或其他應該讓護理人員瞭解的疾病程度DietActivityMedications最好用學名，並註明劑量，儘量不要寫幾顆或幾瓶IV fluids
6 Discharge Orders 醫囑寫法 出院指示 Discharge this afternoon Discharge tomorrow morningDischarge against medical advice (簡寫為discharge AMA，最好不要寫AAD)不宜寫may be discharge (MBD)！出院指示出院處方必須寫藥的學名、劑量、服用方法、供應天數。後續安排OPD F/U in 3 days; Referred back to Dr. Lin’s clinic
8 Admission Note Chief Complaints Present Illness Past History Personal, social and occupational historyFamily HistoryReview of SystemsPhysical ExaminationImage and LaboratoryImpressionPlan of management and treatment
9 Admission Note Chief Complaints 用病人自己的話來描述發病時間不要只寫出日期、月份或星期× Abdominal pain since last Sunday.精簡，適當的形容詞Progressive abdominal distention 4 days before (或prior to) admission.Intermittent abdominal pain for 4 hours.Sudden onset of sharp epigastric pain for 2 hours.Tarry stool over the past two days.不能只寫 for operation, for chemotherapy…，要加上為什麼要做上述治療！e.g. Colon cancer diagnosed 2 weeks ago.
11 Writing “Present Illness” 1.開場白-選擇基本資料中之關鍵詞，融合過去相關病史及主訴作為開場白，如此可將病例的全貌摘要地呈現出來，有助於列舉出各個問題，並開啟解決問題的步驟。例：This 65 year-old man, who is a construction worker with a history of appendectomy, was admitted from our ER because of intermittent abdominal pain for 2 days.SKH
13 Admission Note Present Illness 【例】The 50 y/o male patient is a case of hypertension, DM and old CVA for 10 years with regular medications.不要稱病人為male or female – man or woman, boy or girl.避免稱病人為 “a case” – The patient has had hypertension…“regular medications” – taking medicine as ordered
14 Present illness 的寫法 不完整電報式子句 High fever up to 39°C, sudden onset, daily spike for 4 days; rigor (+) initially; slight dizziness (+) ; poor appetite (+); severe malaise (+)。Visited Dr. Chen’s clinic (Address:…, Tel#:…) daily for 3 days, IV injection daily and two kinds of t.i.d. tablets; no improvement。[查問症狀初發時正在做什麼，可以刺激病人的回憶]。Muscle ache(+), generalized, severe; mod. bitemporal headache (+).Dry cough, dyspnea, since this morning; rapidly progressive. Came to ER。 Needed oxygen right away。No urinary or respiratory symptoms. Loose stool x 2; nausea (+)
15 Admission Note Past History 一般以發生時間的先後決定記載的次序。手術史 : 手術之時間、當時的診斷、有無器官切除、有無輸血、住院多久、追蹤多久。藥物史需特別著重過去對藥品的過敏反應，包括多久以前發生，藥物名稱、發生時的症狀及其處理辦法。
16 Admission Note Personal, social and occupational history 生產史、發展史、教育程度、職業現況(職業與職稱)、婚姻狀況嗜好、習慣、飲食睡眠情況有無抽煙(量及期間)、喝酒(量及種類)、咖啡、檳榔、藥物月經、懷孕、生育史
17 Admission Note Family History 遺傳或接觸性疾病：過敏、癌症、感染性疾病、精神疾病、糖尿病、高血壓、心臟病、腎臟病、癲癇、痛風、中風…等包括至少三代族譜的繪畫
21 Admission Note Impression 診斷應儘量完整，少用簡寫，除了病名外最好加上程度。Cirrhosis, alcoholic, Child class C;Spleen laceration, Grade I, hemodynamic stable;Old CVA, with right hemiplegia小心用R/O，不要沒有其他診斷就直接寫rule out XXX.Fever, suspected of UTI, R/O drug fever.如果診斷暫時無法確定，可以寫fever或chest pain, cause to be determinedImpression之後宜有Differential Diagnosis.
22 依處置之優先順序順列，列出預計檢查與治療的計劃，包括照會、用藥等。 Admission Note Plan依處置之優先順序順列，列出預計檢查與治療的計劃，包括照會、用藥等。不要只寫：To give iv fluids.To give antibioticsTo give antihypertensives藥名最好用學名、寫明劑量、給藥途徑及頻率。
23 Progress Note 的寫法一般以Problem-Oriented Medical Record (POMR) 的方式來書寫，最常採用Subjective-Objective-Assessment-Plan (S.O.A.P.) 模式，針對每一個active problem逐項(或擇要)寫出SOAP，特別注意病情的變化、評估及處理方式。應每天書寫，內容不能一成不變，切忌張貼同樣字句！！無用的數據不必每天打（貼）！主治醫師應counter-sign (複簽)，並加以修改或評語與追加。不論何種方式，其內容：一定要記載已接受的治療、病情的進展及對醫療效果的評估。
24 SOAP 記錄方式 S (subjective): symptoms (chief complaints) O (objective): signs (physical exam) & lab resultsA (assessment): impression/diagnosis and patient or disease conditionP (plan): approaches to diagnosis (lab tests) approaches to therapy (medications, procedures, operation, etc.) approaches to healthcare educationSKH
27 :00 PM# Swelling of the right side cheek 3 days aftersurgery.S: Swelling of the right cheek.O: 1. Intraoral exam revealed erosive and swelling of thesurgical site of 48 region.2. There was no evidence of bleeding, nor exudation.3. Panoramic radiograph showed no retained rootfragment of 48.A: 1. Dentigerous cyst, LR s/p cyst enucleation for 3 days2. 48 impaction s/p odontectomy for 3 days3. Edema over right cheek, more severe than yesterdayP: 1. OHI.2. Hot compression, 20 min/hr.
28 Assessment 錯誤的寫法 只重複寫出住院時之impression而沒有評估 Sepsis, R/O pneumoniaDM type 2Cervical CA, S/P total hysterectomyDiarrhea
29 Assessment / Plan 的寫法(例一) 給了什麼治療？有沒有好轉？為什麼？以後如何處理？ Sepsis, R/O pneumonia: 3rd day of cefuroxime 1.5 gm. q8h. Clearly improving. To continue the same Rx. for 6-7 days.DM type 2: Sugar level is under control with …..History of cervical CA S/P total hysterectomy : Checked by Gyn. No signs of recurrence.Diarrhea has stopped 3 days after admission. Stool culture (-), cause unknown; related to the pneumonia?(隨期間而會逐漸改善的治療，如抗生素、手術後、及其他大部分處理，應該寫今天是第幾天的治療)
30 Assessment / Plan 的寫法(例二 ) 給了什麼治療？有沒有好轉？為什麼？以後如何處理？ High fever: Received 5 days of empiric clarithromycin 500 mg, bid. Does not seem to be improving. May be viral infection. Will D/C the antibiotic and observe. To check the report of influenza, parainfluenza virus antibodies. Renal function is worsening, will check for Hantavirus and Leptospira antibodies. No jaundice.Vomited twice yesterday. 2 hours after lunch. No diarrhea. No meningeal signs. Cause not clear. To continue observation.
45 性別、所有格的錯誤 ** Do not just use male or female; write “man” or “woman”. 【例】：Patient is a 62 years old female, his chief complaint is abdominal pain.建議：The Patient is a 62 years old woman, her chief complaint is abdominal pain.＊有關主訴（chief complaint）的寫法：1. The patient is a 62-year-old woman, and her chief complaint is abdominal pain.2. A 12-year-old girl complained of abdominal pain.3. A 7-year-old boy was admitted to the hospital because of abdominal pain.A 40-year-old man presented with abdominal pain.** Do not just use male or female; write “man” or “woman”.
46 時態 (tense) 的錯誤【例】：He had hypertension and still on three kinds of antihypertensive.建議：He has hypertension and still on three kinds of antihypertensives.He has hypertension and is on three kinds of antihypertensives.He has hypertension and is on three kinds of antihypertensive medications.【例】：Before he came to our clinic today, he had ever went to another two hospital clinics.建議：Before he came to our clinic today, the patient had visited clinics at two other hospitals.建議：Before he came to our clinic today, the patient had been to clinics at two other hospitals.
47 介系詞的錯誤 【例】：In last Saturday, his headache was suddenly got worse. 建議：Last Saturday, his headache suddenly got worse.【例】：The patient had an acute process superimposed to his background conditions.建議：The patient had an acute process superimposed on his background conditions.【例】: A 45 year-old woman of mitral stenosis…..建議 : A 45 year-old woman with mitral stenosis….
48 主詞的錯誤 建議： 【例】：Cancer was told 這是主詞弄亂了。 The patient was informed to have cancer.The patient was told to be having cancer.He was diagnosed to have cancer.He was told to have cancer.
49 單字、單詞的錯誤 【例】：Acception note 建議：沒有acception一字，應該是 acceptance note 或 on service note (相對的可寫off service note)【例】：Progression note；Progressive note.建議：應寫成 Progress note。【例】 : Past history: Nil.建議 : Nil is a Latin word; it means “nothing” or “Zero”. 應寫成 “Non-contributory”.
51 錯誤使用 positive 或 negative 【例】：The biopsy was negative. The exercise testwas positive. The ECG was negative.檢驗結果不要用“positive”或“negative”這些應該寫為：Laboratory tests (studies) gave normal results.Laboratory tests showed normal values.Laboratory data were normal (or within normal limits).The result of the biopsy was unremarkable.The exercise test was abnormal.The ECG revealed no abnormality.
52 Nothing particular (N.P)或non-made的誤用 在病歷書寫時應避免寫“無特殊之處”，應該寫出詢問出什麼，結果正常、或無發現；或是做了檢查，結果正常。故英文應用negative for, unremarkable, non-contributory等字詞。【例】：The family history was nothing particular.應改為：The family history was unremarkable (or non-contributory).Non-made是說做了切片檢查，沒有發現不正常的（癌）細胞。但是，英文不這麼說。【例】：The biopsy was non-made. The pathology was non-made.應改為：The pathology did not reveal malignant cells.或是No malignant cells were found in the biopsy specimen.
53 贅語或俗語 常使用兩個名詞連在一起，或是為節省書寫將一些簡寫當作名詞或動詞。 肝硬化應該是cirrhosis，而常寫成liver cirrhosis或是cirrhosis of the liver. Cirrhosis本身就是肝硬化，因此不須加上liver。seizure attack, 只需寫seizure，或epileptic fit。a tumor mass，應寫為 a tumor, a mass (lesion)。fever of 38°C應寫為 (fever with) a temperature of 38°C。The patient was AAD (against advice discharge, 自動出院)，應寫為The patient was discharged AMA (against medical advice) 或 to be discharged AMA 或 discharge AMA。The patient MBD (may be discharged ) today. 意思是“可以出院”，應寫為The patient is ready for discharge today.或to be discharged；discharge today；discharge tomorrow morning 或 discharge in AM 。
54 其他常見的不當使用語詞VictimVictim翻譯是“受害者”，病人雖然受病痛，但是使用這個字不當。何況已經寫patient，不須再用victim。【例】：The patient is a victim of type 1 DM diagnosed since 2 years ago.應寫為：The patient was diagnosed as having type 1 DM two years ago.【例】 : The patient is a victim of motor vehicle accident (MVA).應寫為 : The patient had a MVA.
55 其他常見的不當使用語詞 Unfortunately 常見病歷寫〝Unfortunately, the patient had…..〞，這個意思是說病人的情況本來是穩定的，但是後來發生了某些症狀或是事件。病人生病本來就是不幸的事，不須再強調，不須以哀傷的語氣如unfortunately、sadly、miserably、unluckily等呈現在病歷。【例】：Unfortunately, nausea, vomiting and abdominal pain developed since last night, and the patient was brought to ER for help.應改為：The patient was well until last night when nausea, vomiting and abdominal pain developed, and he was brought to the ER.
56 其他常見的不當使用語詞A test (or examination) was arranged (performed), which showed…不須寫安排或者執行什麼檢查，直接寫出檢查發現什麼即可。【例】：CT scan of the head was arranged (performed), which showed subdural hematoma over the left parietal area.應改為：A CT scan of the head showed subdural hematoma over the left parietal area.
58 其他常見的不當使用語詞 According to the statement of the patient 這似乎強調這份病歷是病人親口說的，其實病歷不是司法的筆錄，只要說是根據病人或誰陳述即可，或是直接說病人如何。應改為：According to the patient, …. 或 The patient stated that she had epigastric discomfort 30 minutes after last dinner.According to the patient’s mother,
59 其他常見的不當使用語詞During the period of admission這是中式英語的另一例子，亦即“住院期間”。但是admission是由醫院進入病房的一個行為，因此沒有所謂period。應該寫為During the hospitalization或是During the hospital stay。
60 其他常見的不當使用語詞 A disease was diagnosed. The patient was diagnosed as a disease.中文的意思是很簡單，“病人診斷什麼病”，但是英文不能寫為“疾病被診斷”；也不能寫為 “病人被診斷成（as a disease）什麼病”。【例】：Colon cancer was diagnosed.應改為：The patient was diagnosed as having colon cancer. 或是 A diagnosis of colon cancer was made.
61 其他常見的不當使用語詞 使用太多連接詞，使句子太長 The patient went to the hospital and was diagnosed of osteoarthritis, so medications were given and the pain decreased in severity, but she had to take the medicines regularly.應改為：The patient went to the hospital, where a diagnosis of osteoarthritis was made. She took analgesics regularly with some relief of her pain.
62 其他常見的不當使用語詞 Irregular control, Regular medication 常看到病歷寫irregular control或irregular medication或regular medication。例如，The patient has hypertension for 10 years with irregular medications. 這也是中式英語，意思是說病人規則(按時)或不規則(不按時)服藥。先說regular medication並不能說病人一定是按時服藥，服一天藥休息一天，也是“規則“的。因此相對的“不規則“也顯得沒意義。不按時服藥可能是病人疏忽、不在意自己的病情、或是服藥發生不良反應。這些應該區分清楚，才能進一步對病人處置。應該修改為：The patient has had hypertension for 10 years, but he did not take medicine as ordered.The patient has had hypertensive for 10 years, but he has not been taking medicine regularly.
63 其他常見的不當使用語詞EverEver一字英漢字典翻譯成「曾經」，但其實是at anytime past or future, 有always constantly之意，不能依中文「曾經」的用法在英文句子中出現！【例】：The patient ever went to a hospital.建議：The patient has been to a hospital.The patient did go to a hospital.The patient went to a hospital.
64 其他常見的不當使用語詞 【例】：The patient is anemia. Conscious: clear. 形容詞【例】：The patient is anemia. Conscious: clear.建議：The patient is anemic. 或 The patient has anemia. Consciousness: clear. 或 Consciousness: alert,【例】：Mentality clear建議：mentality是智力、悟性，通常病患並不做智力測驗，應該寫Consciousness (知覺、意識) clear。名詞
65 其他常見的不當使用語詞 In vain 【例】 The patient went to an LMD for treatment but in vain.建議：The patient went to an LMD for treatment, but the symptoms did not improve. (或 the treatment was not effective)病人不是“去”醫師診所這件是徒然無功(迷路了)，〝in vain〞此字非專業用語。
66 其他常見的不當使用語詞 【例】：The patient developed abdominal pain and high fever. 建議：Abdominal pain and high fever developed.因症狀不是病人使它發生。【例】：Thank you for the consultation.建議：Thank you for the referral. Thank you for the consultation request. 或簡單地 Thanks!但不能寫Thank you for the consultation（這樣寫變成感謝自己的意見了）。【例】：Dear Dr.；We sincerely request…建議：會診單本來就是要求醫師來評估、建議，本來就是看得起被要求會診的醫師而發。因此 Dear Dr. ; We sincerely request…; your expertise…; 等等敬頌詞句被省略也應該不失禮。
68 病人或家人描述 陳述 Tell, state, claim, assert, describe, said 認為 Think, feel, believe, suspect根據、聲稱According to根據所憶To the best of one’s memory, as one’s recall就其所知To one’s knowledge, as far as one knows
69 ExamplesThe patient stated (claimed, said) that he had abdominal pain just after meals.The patient suspected (thought) that he acquired his infection during a journey to the Mainland China one week ago.According to the patient’s son, he was noted disoriented in time about 2 weeks ago.
71 ExamplesThe patient began to have diarrhea 3 days ago. (Diarrhea started 3 days ago.)Initially the patient had poor appetite and nausea, and jaundice became manifested (appeared) 3 days later.A inguinal bulging mass was noted (found) during routine physical examination at school.The patient was noticed to have elevations of serum creatinine and uric acid at the annual medical checkup.The patient was suddenly suffered from a severe pain in the right upper quadrant of the abdomen.The patient experienced a gradual onset of pain around the lower back.A chest x-ray examination revealed (showed) an abnormal infiltration in the right upper lung.
72 就診、住院、出院、進行檢查或處置 就醫、求診 Call (get, send for) a doctor, seek medical advice, consult (see, visit) a doctor入院Admission to a hospital, be hospitalized (admitted), enter出院Be discharged, discharge, leave a hospital回診、複診Revisit, return visit, follow-up visit進行檢查或處置Undergo a test, do, take
73 ExamplesThe patient sought medical advice for the swelling of his scrotum.He was admitted (hospitalized) because of chest discomfort and palpitation for one day.The patient visited 台中榮總 and was told to have colon cancer.A blood test was done (taken), and the result showed 50mg/dl of blood sugar.The patient underwent an emergent laparotomy and colon perforation was noted.
74 描述過去健康情形 健康狀況 Healthy, well, poor, ill 活力 Healthy, energetic, vigorous 健壯Strong, robust虛弱、生病Weak, sick, ill, be afflicted with, be indisposed with臥床Be bedridden, be ill in bed, be confined to bedvigorous KK: [‘vigeres ] a. (形容詞 adjective)1. 精力充沛的;壯健的2. 強有力的indispose vt. (及物動詞 transitive verb)1. 使不願;使厭惡2. 使不能;使不適合
75 ExamplesThe patient had been in good health (had been well) until 2 weeks ago when she had severe chest pain, which occurred suddenly after paroxysmal cough.This 50 y/o man had enjoyed an excellent health until one month ago when he experienced occasional low abdominal pain.The patient has been bed-ridden (confined to bed) with paraplegia since the traffic accident happened to him one year ago.The patient was afflicted with diabetes for many years.Paroxysmal 陣發性的
76 發病時間、發病狀況入院前Before (prior to) admission (entry, this visit, hospitalization)來診前dated back to 3 days ago住院中During admission (hospitalization, hospital stay)突然的Suddenly, abruptly, an abrupt (acute, sudden) onset徐徐的Slowly, gradually, insidious, a gradual onsetinsidious KK: [in’sidi e s] a. (形容詞 adjective)1. 陰險的;狡詐的;暗中為害的2. (疾病等)不知不覺間加劇的;隱伏的
77 ExamplesSevere abdominal pain and high fever before admission (prior to this entry, hospitalization).During the three months before entry, the patient experienced progressive loss of weight and appetite.The onset of abdominal pain can be dated back to one week ago.During the admission, the patient was treated with antihypertensives.The patient experienced an abrupt onset of chest pain and dyspnea.He had swelling of the lower legs gradually (insidiously).
78 症狀描述 – 部位發生在部位Be located, be situated (in, at, over), be felt, be present局限於Be localized, be limited, be restricted, locally全身性的General, generalized, systemic, the whole body, over the entire body蔓延至、放射至、轉移至Spread, extend, reach to, diffuse, radiate, migrate, shift to
79 ExamplesThe burning sensation was located (felt) in the left shoulder.The reddish skin was localized (limited) to the right instep and did not extent above the ankle.The sharp pain started in the right flank and radiated to the right hypochondrium and even down to the scrotum.The pain began in epigastric area and then shift to right lower quadrant of the abdomen.Instep 腳背
80 症狀描述 – 頻率 長期、慢性的 Long-term, long-standing, chronic, prolonged 短期、急性的 Short-term, brief, a short duration, acute偶爾、發作幾次Occasionally, on one occasion, an episode of, scanty, paroxysmal持續的、時常的Continuously, constantly, persistent, frequently last一時性、間隔的Temporary, transient, fleeting, intermittent off and on, fluctuating
81 Examples Tarry stool persisted over the next five days. For the past two weeks, the patient has had several paroxysmal dyspnea, which usually occurred at night and lasted for about 15 minutes.Constipation and diarrhea came alternately (alternative constipation and diarrhea).The blood-tinged stool was noticed at least on two occasions.
82 症狀描述 – 嚴重度 輕度 中度 重度 Mild, slight, a touch of Moderate, proper Severe, intense, violent, marked輕症A slight illness, a minor (mild) injury (attack)重症A serious illness, seriously (gravely, critically) ill, severely (badly) injured, in a critical condition痛的描述Sharp; vague; crampy; stinging; tinglevague KK: [vag ] a. (形容詞 adjective)2. (想法等)不明確的;曖昧的,含糊的3. 無表情的4. (在否定句中用最高級)少許的[B]Stinginga. (形容詞 adjective)1. 刺般的;激烈的2. 尖酸的;刺痛的Tinglevi. (不及物動詞 intransitive verb)1. 感到刺痛;感到臉紅[(+with)]His cheek tingled from the slap she had given him.他的面頰因挨了她一記耳光而感到刺痛。2. 震顫;激動[(+with)]She was tingling with excitement.她激動不已。3. 發出叮叮聲;發出鈴鈴聲;(耳等)鳴響My ears often tingle.我常常耳鳴。vt. (及物動詞 transitive verb)1. 使感刺痛;使激動2. 使發叮叮聲;使發出鈴鈴聲n. (名詞 noun)[S]1. 刺痛;震顫;激動The cold caused a tingle in my fingers.嚴寒使我的手指有刺痛感。She feels a tingle of excitement.2. 叮叮聲;鈴鈴聲;(耳等的)鳴響
83 Examples The epigastric pain gradually increased in severity. The chest pain, localized mostly over the left lateral chest, decreased in severity or was minimal when breath was held, but was aggravated by inspiration.The patient remained gravely ill after cholecystectomy, although his jaundice and liver function were not deteriorated.The patient suffered from vague (cramp) abdominal pain for one week.
84 症狀描述 – 量化及形容量A little, scantly, plenty of, a large (small) amount, gain (loss) weight, bulky數、次數A few, small in number, numerous, a large number of, increase (decrease) in number大小Be the size of, sized of, diminish (decrease; increase) in size (length, width)形狀、顏色In shape, shaped, be tinged (tinted) withtinge KK: [ ] DJ: [ ] n. (名詞 noun)1. (較淡的)色調,色彩[C][S1][(+of)]Her hair has a tinge of red.她的頭髮帶著一點紅色。2. 些許味道(或氣息);一絲痕跡(或性質)[S][(+of)]The music had a tinge of sadness.這音樂帶有一絲悲傷。vt. (及物動詞 transitive verb)[H][(+with)]1. (輕淡地)給...著色,染His black hair was tinged with gray.他的黑頭髮帶著一點灰白。2. 使帶有...氣息(或痕跡等)Mary's admiration for Jane is tinged with jealousy.瑪麗對珍又羨又妒。Her admiration for him was tinged with jealousy.她對他的欽佩帶有一點妒忌。tinted KK: [ ] DJ: [ ] a. (形容詞 adjective)1. (用作定語)(玻璃等)著色的
85 ExamplesThe patient had intermittent cough for more than 20 years, and began to have a small amount of blood-tinged sputum in recent three months.A hen egg-sized lump has been noted on the abdominal wall without change in size or shape for the past ten years.The patient loss his weight from 70 kg to 60 kg within 2 months.Numerous pinhead-sized papules initially occurred over the chest, increased rapidly in number and spread to the neck and face.
86 症狀描述 – 症狀的誘因誘發、引起、影響Trigger, cause, precipitate, induce, bring about, provoke, influence, affect前因Precede, antecedent傾向Tend to, be apt to, have a tendency to
87 ExamplesThe patient cannot recall any precipitating (provoking) factor of the attack.The chest pain was induced by walking for about 10 minutes and disappeared after taking a rest.The cramping ache was present constantly in the lower abdomen, unaffected (not influenced) by meals or bowel movement.The patient had a tendency toward cold sweating and dizziness before lunch, which could be relieved by taking a snack.
88 症狀描述 – 伴隨或相關症狀伴隨With, along with, concurrently, coincide with, accompany, simultaneously合併Be accompanied by, be complicated with (by), concur續發Following, be followed by, succeed, ensue相關、有關連Be related to, be associated with, have nothing to do withensue KK: [ en’su ] vi. (不及物動詞 intransitive verb)【書】1. 接著發生;接踵而來2. (因...而)產生[(+from)]
89 ExamplesConcurrently, the patient had abdominal pain and diarrhea, in addition to vomiting.Epigastric pain persisted and was unrelated to meals.The chest pain was closely related to (associated with) position, movement, and swelling.The cough was followed by dyspnea and fainting attack few minutes later.The fracture of the left femur was complicated with pulmonary embolism.
90 症狀描述 – 姿勢或活動的相關症狀 運動 On exertion, on exercise 排尿 On urination, when voiding仰臥、平躺A recumbent position, a lying position, in a supine position俯臥In prone position, in a ventral decubitus側臥On (right or left) decubitus蹲On squatting彎腰In a leaning (stooping, reclining, stooping) position爬樓梯Climbing stairs受限制Limit, restrict, confine有困難Trouble, difficult受干擾Prevent, disturb, interrupt困擾於Annoy, bother, trouble
91 ExamplesThe patient often felt dizzy when rose suddenly from recumbent or sitting position.The backache was mild on standing erect, and could be partially relieved by bending forward.The pain could be significantly decreased by lying on his right decubitus.
92 症狀描述 – 病情變化病況變好、緩解、減輕Progressing favorable, doing well, make a favorable progress, relief, remission, palliation, lessen, diminish, subside, improve, reduce, got better, decline病況轉壞、惡化Aggravated, worsen, getting worse, progressively worsening, an unfavorable progress, degenerated復發Relapse, recurrence, flare-up, recrudescence接受治療Receive (take) treatment, be under treatment, drugs be prescribed
93 Examples After the operation, the patient made a favorable progress. The pain of ankle was relieved promptly after the patient took the doctor’s prescription.In spite of intensive management of his heart failure, the patient’s consciousness got worse and was aggravated by pneumonia.The leg edema subsided gradually after the patient took diuretics.