胰腺癌Chapter 13 Pancreatic cancer
学习目标
1.胰腺癌的主要治疗方式
2.支架植入的手术途径
3.支架植入术后的注意事项
4.掌握以下词汇
massage 按摩
strenuous exercise 剧烈运动
treatment plan 治疗计划
significant pain 明显的疼痛
bile ducts 胆管
jaundice 黄疸
Xiao Rui is a patient in bed #20.She was diagnosed with pancreatic cancer a week ago and is waiting for treatment in hospital now.Su Shan is her primary nurse.She is talking with the patient.
Su Shan: Morning, Xiao Rui.How are you feeling today?
Xiao Rui: Morning, Su Shan.Just as usual.You know, I'm not feeling well recently.Is there any better treatment plan?
Su Shan: The treatments for pancreatic cancer are surgery,implantation ofI125 seeds or stent under the guidance ofendoscope.
Xiao Rui: What should I pay attention to after the operation?
Su Shan: There are precautions after placing stent.To prevent the detachment or dislocation of stent, you should not massage your abdomen and should avoid strenuous exercise.Besides, keep offcold food or the food with coarse fiber.In case of abdominal pain after discharge, you need to seek medical attention immediately.
Xiao Rui: Thank you for your detailed explanation.And I have one more question — why do I feel no pain? Pancreatic cancer is known to cause severe pain.
Su Shan: You are right, that's a very professional question.Most people know that pancreatic cancer is the most lethal tumor causing intolerable pain.From a professional viewpoint, we need to identify the location of the tumor.If the tumor is in the tail of the pancreas, close to the posterior peritoneal plexus, the patient may feel significant pain.If the tumor is in the head or neck of the pancreas, it can block the bile ducts, the pancreatic ducts,even the duodenum, and the patient may have difficulty eating,accompanied byjaundice and other symptoms.
Xiao Rui: I see.My tumor is in the body ofthe pancreas, so I feel less painful.Thank you for your explanation.
译文
小蕊是20床患者，确诊胰腺癌1周，目前在医院等待治疗方案。苏珊是她的责任护士，正在与她交流。
苏珊：早上好，小蕊，今天觉得怎么样？
小蕊：早上好，苏珊，还是老样子，你知道我最近不太舒服，没有更好的治疗方案吗？
苏珊：胰腺癌的治疗方案主要有外科手术治疗、内镜下植入I125放射性粒子或胰管支架。
小蕊：我手术后需要注意些什么？
苏珊：放置支架后有一些注意事项。为了预防支架的脱落或移位，首先要避免剧烈运动和按摩腹部，其次不可以进食过冷的食物，同时也要避免进食粗纤维。如果出院后你有腹痛的话，需要及时到医院就诊。
小蕊：谢谢你详细的解释。我还有一个问题，为何我感觉不到疼痛。你知道，胰腺癌是以疼痛著称的。
苏珊：是的，你的问题很专业。很多人都知道胰腺癌是癌中之王，疼痛难忍。从专业的角度，我们要评估肿瘤的位置。如果肿瘤位于胰腺尾部，靠近后腹膜神经丛，患者的疼痛会很明显；如果肿瘤在胰腺头颈部，它会阻塞胆管、胰管甚至十二指肠，患者可能有进食困难，同时伴有黄疸和其他症状。
小蕊：我明白了，我的肿瘤是在胰腺体部，所以我的感觉较轻，谢谢你的解释。