骨科英文书籍精读（197）｜骨盆骨折早期处理（2）
中国十大名师之一赖世雄老师说过，学习英语没有捷径，少就是多，快就是慢。不要以量取胜，把一个音标、一个单词、一段对话、一篇文章彻底搞透，慢慢积累，你会发现，你并不比每天走马观花的输入大量英文学的差。
With any severely injured patient, the first step is to make sure that the airway is clear and ventilation is unimpaired. Resuscitation must be started immediately and active bleeding controlled. The patient is rapidly examined for multiple injuries and, if necessary, painful fractures are splinted. A single anteroposterior x-ray of the pelvis is obtained.
A more careful examination is then carried out, paying attention to the pelvis, the abdomen, the perineum and the rectum. The urethral meatus is inspected for signs of bleeding. The lower limbs are examined for signs of nerve injury.
If the patient’s general condition is stable, further x-rays can then be obtained. If a urethral tear is suspected, an urethrogram is gently performed. The findings up to that stage may dictate the need for an intravenous urogram.
By now the examining doctor will have a good idea of the patient’s general condition, the extent of the pelvic injury, the presence or absence of visceral injury and the likelihood of continued intra-abdominal or retroperitoneal bleeding. Ideally, a team of experts will be on hand to deal with the individual problems or undertake further investigations.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
unimpaired /ˌʌnɪmˈperd/adj. 未受损伤的；没有削弱的，未减少的
impair /ɪmˈper/vt. 损害；削弱；减少
repair/rɪˈper/v. 修理；修复，补救；（使）重归于好；（结伴）去
Resuscitation /rɪˌsʌsɪˈteɪʃn/n. 复苏；复兴；复活
perineum /ˌperɪˈniːəm/n. [解剖] 会阴
rectum. /ˈrektəm/n. 直肠
urethral meatus尿道；尿道口
inspect/ɪnˈspekt/vt. 检查；视察；检阅vi. 进行检查；进行视察
suspect /səˈspekt/v. 怀疑；猜想n. 嫌疑犯adj. 靠不住的；可疑的
dictate/ˈdɪkteɪt/n. 命令；指示vt. 命令；口述；使听写vi. 口述；听写
intravenous urogram静脉尿路造影
extent/ɪkˈstent/n. 程度；范围；长度
visceral /ˈvɪsərəl/adj. 内脏的；出于本能的；发自肺腑的；粗俗的
visceral injury 内脏损伤
retroperitoneal /'retrəu,peritə'ni:əl/adj. 腹膜后的
百度翻译：
对于任何严重受伤的患者，第一步是确保气道畅通，通风畅通。必须立即开始复苏，并控制活动性出血。患者迅速检查是否有多处损伤，如有必要，疼痛性骨折被夹板固定。获得骨盆的一个前倾物x光片。
然后进行更仔细的检查，注意骨盆、腹部、每一个神经和直肠。尿道道检查有无出血迹象。下肢检查是否有神经损伤的迹象。
如果患者的一般情况稳定，则可以获得进一步的x光。如果尿道撕裂被检查，则轻轻地进行尿道造影。到那个阶段的发现可能决定了静脉尿路造影的必要性。
到目前为止，检查医生将对患者的一般情况、骨盆损伤的程度、内脏损伤的存在或无以及持续腹腔或腹膜后出血的可能性有一个很好的认识。理想情况下，专家组将在手，处理个别问题或进行进一步调查。