10. Congestive Heart Dia
This chapter emphasizes the special features characterizing the diagnosis and treatment of congestive heart failure①, who high incidence in old age makes it an important problem of older people.
Heart failure in the aged may result from any condition②which interferes with the coronary blood flow, increas the work of the myocardium, or impairs myocardial function. Age- specific rates demonstrate a remarkable increa in congestive heart failure with age. Atherosclerotic heart dia and hypertensive heart dia parately or combined③account for nearly 50 per cent of the reported cas of congestive heart failure.
unluckyAdvances in treatments available to younger patients are equally valuable to older patients although treatment of congestive heart failure in old patients pos problems of greater magnitude than in younger persons and requires Special consideration owing to the multiple pathological ailments and changes in pharmacological respons with age④. For example, the elderly patient’s extensive ⑤coronary artery dia and myocardial fibrosis impair heart action and decread⑥cerebral blood fl
ow and hypoxia produce irrational behavior which makes the older person more difficult to manage and less capable of following directions. Chronic renal and liver impairments make older people more susceptible to digitalis toxicity, electrolyte disturbances, and hypoproteinemia. Although the
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changes tend to thwart therapeutic efforts and render management more difficult, attention⑦to the diagnostic and therapeutic suggestions in this chapter should rectify and prevent recurrent congestive heart failure and provide more successful care in the hospital and at home.
The pathology of heart failure in the aged includes all form of heart dias in younger people and, in addition, the special entities found mainly in the elderly. The multiplicity of pathologic conditions increas with age and complicates the asssment of the pathologic basis for the heart failure⑧. Heart failure in aged patients often has more than one cau and may be associated with numerous other disorders⑨.for是什么意思
From The Management of Geriatric Cardiovascular
Dias by Raymond Harris 【参考译文】
本章着重讨论在充血性心力衰竭的诊断与治疗中存在的特殊问题。由于充血性心力衰竭①在老年人中的发病率颇高，因此该病便成为老年病中的一个重要课题。
老年人心力衰竭可由冠状动脉血流障碍②、心肌负荷过重或心肌功能障碍造成。资料显示，充血性心力衰竭发生率随年龄增长而明显增高。动脉硬化性心脏病和高血压性心脏病单独或并存③几乎占已报道的充血性心力衰竭病例的50%。
老年人心力衰竭的治疗比年轻心衰病人的治疗更加困难。由于年老，病人常有多种疾病并存，而且对药物反应也有改变，所以治疗时应顾及老年人的特殊性。不过，在年轻病人中采用的新治疗方法仍然适用于老年病人④。老年人广泛的⑤冠状动脉硬化以及心肌纤维变化影响心肌活动功能，而脑血流减少⑥及缺氧又可引起非理性行为，结果，病人不能遵守医嘱rule
接受治疗，致使病人更难处理。此外，在有慢性肝肾疾病的老年病人中更容易出现洋地黄中毒、电解质紊乱、低蛋白血症。虽然这些病理变化都可能影响有效的治疗，使病人的管理更加困难，但如果医生能注意⑦本章中强调的诊断和治疗的建议，应能防止充血性心力衰竭的复发，并可使医院和家中的医护更成功。
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老年人心力衰竭的病理变化与年轻人的各类心脏病的病理变化相似。除此之外，老年人还有其特殊性。由于年老，常有多种疾病并存的情况，致使对心力衰竭病理基础的评估更加复杂化⑧。老年人心力衰竭常有几个原因，而且可能有各种其他疾病⑨并存。mi manchi翻译中文
(叶子南译) 【翻译要点】
①congestive heart failure在中国内地的医学文献中多处理为“充血性心力衰竭”。
②condition多指“状况”，但在医学文献中condition常指病，在与coronary blood flow 搭配时，常译为“冠状动脉血流障碍”。
③parately or combined应指两种病“单独或并存”，这里涉及到具体数字，翻译时要注意其准确性。99宿舍网四六级成绩
④原句句子较长，成分复杂，翻译时可考虑调整句序，将其转化为多个分句或句子。如句中的although结构可考虑将其放在主句的前面，灵活处理。另外，在although领导的从句中出现了owing to结构，也可将其提出，译为分句，并加上连接词“由于”“所以”“不过”等加强分句之间的联系。
⑤Extensive主要指病变范围广泛，在extensive coronary artery dia中最常译成“广泛的冠状动脉硬化病”。
单片机培训
⑥句中的decread为过去分词做修饰语，相当于形容词，翻译时可将其转译为动词“减少”。
考研数学三
gentleness⑦文中并未指出attention的主语，但本文为医学方面的语篇，面向医护人员，因此，翻译时可补充为“医生如果能注意”，显得语意清晰。
⑧句中的the multiplicity of pathological conditions与上文的the multiple pathological ailments应意义类似，只是表达方法不同，因此，可参照上文，译为“有多种疾病共存”。动词complicate则可转移为名词，表示“复杂化”。
⑨disorders在医学用语中应译成“疾病”。
