背景

背景

患者湯女士，74歲，因在陽臺(tái)上搬動(dòng)花盆時(shí)突感腰部疼痛，不能轉(zhuǎn)動(dòng)，X片提示腰椎壓縮性骨折而入院?；颊咂綍r(shí)有骨質(zhì)疏松，背痛，醫(yī)生曾勸她喝牛奶，補(bǔ)點(diǎn)鈣片，但她未遵從醫(yī)囑。

Background

The patient Ms.Tang，74years old，had intense lower back pain after bending over and lifting her flowerpots on the balcony，and was unable to move.The X-ray showed a lumbar vertebra compression fracture，and she was admitted to the hospital.She has been suffering mild back pain for some time.Although the doctor had told her to drink more milk and take calcium pills because of her mild osteoporosis，she did not follow the doctor’s orders.

交流

病人：張護(hù)士，您告訴我，我的骨頭為什么這么不結(jié)實(shí)呢？我不就搬了一下花盆嗎？怎么就斷了呢？

護(hù)士：湯婆婆，您年紀(jì)大了骨質(zhì)減少了，骨頭里有許多小孔，所以不堅(jiān)實(shí)。醫(yī)學(xué)上稱為骨質(zhì)疏松。

病人：那我平時(shí)胃口蠻好的，一天三頓飯吃得好好的，怎么會(huì)骨質(zhì)減少呢？

護(hù)士：您平時(shí)吃點(diǎn)什么？

病人：粥、飯、蔬菜、魚、蛋。

護(hù)士：您吃不吃牛奶、小蝦米、炸小魚、排骨湯之類的食物？

病人：我平時(shí)不吃這些的。我不能聞牛奶的味道，聞到就覺得反胃。還有我的牙不好，小蝦米、炸小魚、排骨等也不太吃。

護(hù)士：您吃不吃鈣片？

病人：哦，有一次我感到骨頭痛，去醫(yī)院看病，醫(yī)生曾叫我吃鈣片，我就吃了半個(gè)月左右的鈣片和維他命D。后來骨痛好了點(diǎn)，我想這是藥片，不能多吃的。

護(hù)士：這是什么時(shí)候的事？

病人：大約三年前的事。

護(hù)士：現(xiàn)在您缺鈣比較嚴(yán)重，以至于容易骨折。我建議您今后每天吃1-2瓶牛奶，菜湯里加點(diǎn)蝦米。平時(shí)也可多吃點(diǎn)深綠色蔬菜、海產(chǎn)品、豆制品和花生。如您實(shí)在不喜歡牛奶，那就吃鈣片。鈣片吃得時(shí)間長一點(diǎn)沒關(guān)系的。這樣您的骨質(zhì)疏松就會(huì)好得多。

Interactions

Patient：Miss Zhang，could you tell me why my bones are so fragile？They fractured as I moved only a few flowerpots.

Nurse：Grandma Tang，this is an age-related bone demineralization called osteoporosis.As people grow older they will lose their bone mass，which makes their bones porous and fragile.

Patient：My appetite is good and I have my normal diet.Why should I loss bone mass？

Nurse：What kind of foods do you usually eat？

Patient：Porridge，rice，vegetables，fish，eggs and so on.

Nurse：Do you take milk，small shrimps，fried little fish，and sparerib soup？

Patient：I do not like the smell of milk and feel nauseous when I smell it.I also seldom eat small shrimps，little fried fish，and sparerib soup because my teeth are not very good.

Nurse：Do you take calcium pills？

Patient：Oh，once a doctor told me to take calcium pills because my bones were aching.I took the calcium pills and vitamin D for about half a month.I stopped taking them after the pain reduced，because I thought these pills were medicines and should not be taken for too long.

Nurse：When was that？

Patient：About 3years ago.

Nurse：You are suffering from severe calcium deficiency now which causes your bones to fracture easier.I suggest that you drink one to two bottles of milk a day，soup with small shrimps，green vegetables，seafood，bean products and peanuts.If you do not like milk，you can take calcium pills instead.I think your osteoporosis will improve if you follow my suggestions.