(二)、异常流血（房事后出血）

CaseII
Good afternoon,I am Dr. Sun,how can we help you today?下午好我是孙医生，我能帮你做什么？
Afternoon, Dr. Sun! There is something scary with my
body. I had abnormal bleeding after I had sex with my husband.下午好，孙医生。我的身体出现了一些可怕的问题。我和丈夫房事后有不正常的出血。
Don't worry too much, I am here trying to help. How
old are you?别太担心，我尽量帮你。你几岁了？
36.
D: Ok. When do you usually have this sort of thing
happen ? Only during intercourse or alsp under other circumstances ? And, how many times has it happened?好的，这样的事通常什么时候发生？只在房事的时候还是其他时候也会？出血有几次？
P: I think it just started to occur during these four months recently. It has happened for four or five times, only during or after 1 have sex with my husband.我想只是最近四个月才发生的。发生了4-5次，只在房事或者房事后发生。
D: Is the bleeding massive? What is the color of the
blood?出血量大吗？什么颜色
P: It is dark, just some spotting. not too much.黑色的，只是一些出血点，不太多。
D: Ok, I see. Do you have any discomforts or other
symptoms? Like abdominal pain or abnormal
discharge?我知道了，有没有其他的不舒服？比如腹痛或者不正常分泌物？
P: No, I never had abdominal pain but, since you
brought up, sometimes I do have abnormal discharge.These were watery and foul smelling.The last onewas several days ago and now it's gone. I didn't pay attention to it. I have been in good health all my life and seldom go see the doctor.没有腹痛，但是既然你提起来，有时我确实有异常分泌物，都是水和难闻的臭味。最后一次是几天前，现在没有了。我没重视。我一直都很健康很少看医生。
Do you get a yearly physical? 你每年常规体检吗？
No, never. I feel pretty healthy all the time.从不，我觉得我一直很健康。
Well, it is necessary for a woman to have a check-up
every year. Sometimes you will not realize that youare il because some diseases are asymptomatic.对于女性来说，每年做一次检查是很有必要的。有时你自己都不知道生病了因为有些病是没症状的。
P: I see. What can I do right now?我明白了，我现在应该做什么？
D: Well, I am going to perform a thorough genital and
pelvic exam to see if there is something wrong with
your cervix, uterus or annex since you have not done for a long time.嗯，我将为你做一个全面的生殖道和盆腔检查，看看你的宫颈，子宫及附件是怎么了，因为你好久没有做检查了。
P: Ok.好的
D: Could you please lie down on your back so I can start the exam? Just relax and don't be nervous. It might be a little bit of discomfort when I am using a vaginal spectrum to expose the cervix.你能躺下吗以便我能为你做检查，放松别紧张，当我用yd镜暴露你的宫颈的时候可能会有点不舒服。
P: That's fine. doctor.好的，医生。
D: Well, I'm done. Based on the visual inspection of the cervix, the gross appearance is relatively normal. Just to be sure, I need to do a cytological test. which is called a pap smear to try to find out the reason of the abnormal vaginal bleeding.好了，我做完了。根据可看见的宫颈部分，宫颈表面大体正常。为了确认，我需要做一个细胞学检查。也叫宫颈细胞学检查来发现异常出血的原因。
P: Thank you very much, doctor!好的，谢谢医生。