對腎癌患者進行醫(yī)學(xué)理論解釋工作是醫(yī)生出診,對病人進行治療的一部分工作,但是由于近期醫(yī)患關(guān)系出現(xiàn)的明顯問題,應(yīng)該從安全的角度對這一問題進行認真的分析?;颊邔︶t(yī)務(wù)人員的不滿有各種原因,但是從安全角度來說應(yīng)該首先保障矛盾雙方的安全。
在警務(wù)人員介入醫(yī)療過程全過程時,需要與多位專業(yè)醫(yī)生協(xié)作,因為患者在對自己病情了解的基礎(chǔ)上,也有選擇治療手段途徑的權(quán)利,作為警務(wù)介入的警務(wù)人員首先要尊重患者的選擇權(quán),在這基礎(chǔ)上對患者選擇的治療方法也要進行相應(yīng)的介紹解釋,以便患者可以在選擇的基礎(chǔ)上更多的了解治療方法,醫(yī)務(wù)人員的選擇以及醫(yī)務(wù)人員的治療效果上有更多的了解。
當病人確診腎癌時,對明細胞癌這個專業(yè)醫(yī)學(xué)術(shù)語有疑問,社區(qū)警務(wù)人員要對病人的提問進行解釋工作,盡量用專業(yè)明了的語言對患者進行講解,讓患者首先對自己的病情有一個大概的了解,用客觀事實的描述,與患者建立起最起碼的信任。在提到一些醫(yī)學(xué)術(shù)語時,一下提供一些標準的對話如下:
A:what is clear cell carcinomas ?
B: usually a solid mass frequently something from the kidney is clear cell carcinomas and often? fixing a fibrous capsule.these tumours can develop very large size .the the color of tumour is? yellow? .the yellow colour is due to? glycogen content and? clear cell appearance on histological exam.
當患者需要做穿刺的時候,警務(wù)人員對患者進行解釋工作時的理論對話,語言素材參考如下:
A:what is the role of percutaneous biopsy?
B:percutaneous fine needle aspiration biopsy is important part of the diagnosis of many solid organ tumours. information of cytology is essential to the beginning of treatment to biopsy of renal tumours .a check is made to ensure normal blood clotting. ultrasound guide the performance and connected to the lesion .usually? being placed in the lateral position .the lesion is? examined . the component is cystic or likely necrotic.? needle trajectory need to aviod possible necrotic center.local anaesthetic is in skin entry site and into the abdonimal wall.needle should be care not to inject any air bubbles as this can be caused the lesion to be obscured.under realtime ultrasound guidance and with suspended respiration ,the biopsy needle is inserted as to the tip of needle just penetrates the lesion.the device is fird.at the end of procedure the patient is rescanned.
當患者需要經(jīng)動脈栓塞治療時,警務(wù)人員做解釋時,提供一些相關(guān)理論參考,如下:
A:what is the embolization in renal cancer?
B: embolization was prior to surgical nephroctomy.the accepted place for embolization in the modulation from advanced RCC . such palliation includes control of haematuria ,hypercalcaemia hypertension .congestive cardiac failure and pain .reported? on patients who did not undergo surgery due to disease ,being unfit for surgery? .all? patients had kidney embolized .
當患者需要做消融手術(shù)時,警務(wù)人員應(yīng)該如何做醫(yī)學(xué)解釋,對話材料如下:
A:how to use image guided ablation?
B: IGA makes significant role in the management of early disease. to destroy living ,perfused tissue is.the targeted use.Cryotherapy has been a practical tool .high intensity focus microwave are disseminated rapidly.RFA is? by means of an exposed antenna .pads are connect to the patient s thighs and tip induces coagulative nercrosis . small cell death occurs .optimal heat transmission from? tip to parts of the lesion.the hoal entire target volume .
警務(wù)人員對腎癌腫瘤分期的解釋和治療方法的說明如下:
A:how does? imaging modalities for staging and what is the surgical technique?
B:the diagnosis of IVC invasion is important determinant when planning the surgical approach . varicocele and engorgement of veins may indicate the vene cava by tumour thrombus .however ,for this reason ,the diagnosis of IVC extension is mainly based on radiology examination.
the incisions are? to thel side or based on? extended down the abdomen as a paramedian incision .both of these incisions are exposure for performing radical nephrectom .the renal artery is divided. kidney connect to the renal vein .it is important not to carry out any unnecessary manipulation of the renal vein.
IVC is carefully cut from the surrounding structures above and below the renal vein .it is important to cut the IVC .this can either be achieved with vascular clamp . the surface of IVC at the junction of renal vein is then cut the tumour thrombus. in most cases there is no connect to the kidney.
警務(wù)人員對于腎切除術(shù)向患者做的醫(yī)學(xué)理論說明:
A:how about laparoscopic radical nephrectomy for renal cell carcinoma?
B:? ?we use technique for? tumours . the initial cut begins to mobilize the kidney.the vena cava on the left are then identified and gonadal vessels are divided. following? vein will helps to identify the renal vein . the renal vein are divided sharply .further dissection proceeds from the upper pole . the adrenal gland is spared. the specimen is removed .
以上是警務(wù)人員對患者做解釋工作的對話提供的語言參考。
有很大一部分患者對腎癌醫(yī)學(xué)理論知之甚少。對患者進行理論醫(yī)學(xué)解釋的目的是讓患者對自己的病情有透徹的了解。但有的時候患者對醫(yī)學(xué)理論的解釋并不能真正的了解。這時就需要警務(wù)人員以問答的方式對患者進行講解。通過警務(wù)人員與患者的溝通,可以更進一步了解患者的需求,警務(wù)人員可以幫助患者搭建適合于患者個人情況的醫(yī)務(wù)人員進行醫(yī)治。
作者簡介:
霍夢陶,(1983-12-21),男,漢族,天津人,本科,研究方向為社區(qū)警務(wù)英語教學(xué),從事公安社區(qū)警務(wù)工作。