有聲英文閱讀-心臟?。河辛瞬〔湃ブ芜€是沒(méi)病先預(yù)防

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Heart Disease: Treat or Prevent?

One of the greatest killers in the Western world is heart disease. The death rate from the disease has been increasing at an alarming speed for the past thirty years. Today in Britain, for example, about four hundred people a day die of heart disease. Western health-care systems are spending huge sums of money on the surgical treatment of the disease.
This emphasis on treatment is clearly associated with the technological advances that have taken place in the past ten to fifteen years. In this time, modern technology has enabled doctors to develop new surgical techniques and procedures. Many operations that were considered impossible a few years ago are now performed every day in U.S.hospitals. The result has been a rapid increase in heart surgery.
Although there in no doubt that a large number of people benefit from heart surgery, critics of our health-care systems point out that the emphasis on the surgical treatment of the disease has three clear disadvantages. First, it attracts interest and financial resources away from the question of prevention. Second, it causes the costs of general hospital care to rise. After hospitals buy the expensive equipment that is necessary for modern heart surgery, they must try to recover the money they have spent. To do this, they raise costs for all their patients, not just those patients whose treatment requires the equipment. The third disadvantage is that doctors are encouraged to perform surgery - even on patients for whom an operation is not at all necessary - because the equipment and surgical expertise is available. A federal government office recently said that major heart surgery was often performed even though its chances of success were low. In one type of heart surgery, for example, only 15 percent of patients benefited form the surgery.
In the recent past, medical researchers have begun to emphasize the fact that heart disease is associated with stress, smoking and a lack of exercise, and we can often reduce the risk of heart disease by paying more attention to these factors.
More and more people are realizing that there is a connection between heart disease and the way they live. As a result of this new awareness, attitudes toward health are changing. In the past, people tended to think that it was sufficient for good health to have a good doctor who could be relied on to know exactly what to do when they became ill. Now they are realizing that merely receiving the best treatment for illness or injury is not enough. They are learning that they must take more responsibility for their own health. Today many people are changing their dietary habits and eating food with less fat and cholesterol. Many are paying more attention to reducing stress in their lives. The number of smokers in the United States is now far below the level of twenty years ago as many people succeed in breaking the habit and as fewer people take it up. More and more people are aware of the benefits of regular exercise like walking, running, or swimming; some have begun to walk or ride bicycles to work instead of driving. Millions have become members of health clubs and have made health clubs one of the fastest growing businesses in the United States today. And now the beneficial effects of these changing attitudes and behaviors are beginning to appear: an encouraging decrease in deaths from heart disease.

心臟病是西方世界的最大殺手之一。在最近三十年以前，心臟病的死亡率正在以驚人的速度上升。例如，今天在英國(guó)每天大約有四百人死于心臟病。西方的各級(jí)衛(wèi)生保健機(jī)構(gòu)在心臟病的外科手術(shù)治療方面正在耗費(fèi)大筆的金錢(qián)。
這種老是強(qiáng)調(diào)治療的作法顯然與最近十到十五年內(nèi)技術(shù)的進(jìn)步有很大關(guān)系。在這一段時(shí)期內(nèi)，現(xiàn)代技術(shù)使醫(yī)生們研制出了一些新的外科手術(shù)方法和程序。兩三年前還認(rèn)為是不可能做的很多手術(shù)，現(xiàn)在在美國(guó)的各大醫(yī)院里每天都在做。其結(jié)果就使對(duì)心臟實(shí)行外科手術(shù)的病例迅猛地在增強(qiáng)。
盡管有很多人從心臟外科手術(shù)中得到了好處，還是不容懷疑的；但是，對(duì)我們的醫(yī)療保健機(jī)構(gòu)提出批評(píng)的人士都指出，強(qiáng)調(diào)用外科手術(shù)治療心臟病的作法很明顯有三大害處。第一，這種作法使得人們?cè)谂d趣和財(cái)力資源的分配上忽略了預(yù)防心臟病的問(wèn)題。第二，這種做法導(dǎo)致了一般的醫(yī)療費(fèi)用的上漲。各醫(yī)院都購(gòu)置了從事現(xiàn)代心臟外科手術(shù)所必須購(gòu)置的昂貴設(shè)備之后，這些醫(yī)院必須千方百計(jì)收回花費(fèi)在這些設(shè)備上的購(gòu)置費(fèi)用，而不僅僅是提高了需要使用這些昂貴設(shè)備來(lái)加以診治的患者們的費(fèi)用。第三個(gè)害處就是鼓勵(lì)醫(yī)生去開(kāi)刀--甚至對(duì)那些根本不需要?jiǎng)邮中g(shù)的病人也給開(kāi)了刀--因?yàn)?，要弄到一張?zhuān)家同意手術(shù)的鑒定書(shū)、要使用這些設(shè)備都是唾手可得的。美國(guó)聯(lián)邦政府辦公廳最近宣布說(shuō)即使成功的機(jī)率很低也還要經(jīng)常對(duì)心臟動(dòng)用外科大手術(shù)。例如，有一種外科手術(shù)，只須15%的患者在手術(shù)后病情有所好轉(zhuǎn)。
最近這幾年醫(yī)學(xué)研究人員們開(kāi)始強(qiáng)調(diào)這樣一個(gè)事實(shí)，即心臟病與人的精神緊張、吸煙成癖，缺乏鍛煉有密切關(guān)系，如果多加注意這些因素我們通常都能降低患心臟病的機(jī)率。
越來(lái)越多的人意識(shí)到人們的生活方式與心臟病之間有密切的關(guān)系。由于認(rèn)識(shí)到了這一點(diǎn)，人們對(duì)待健康的態(tài)度正在轉(zhuǎn)變。過(guò)去多數(shù)人都有這樣一種看法：變?yōu)楫?dāng)人們生病以后，只要能有一位可以信賴的好醫(yī)生，這位醫(yī)生能確切地知道該怎么治，這對(duì)保障一個(gè)人的健康來(lái)說(shuō)已經(jīng)足夠了?，F(xiàn)在人們認(rèn)識(shí)到傷病以后僅僅能得到最好的治療是很不夠的。人們已經(jīng)知道了自己應(yīng)當(dāng)對(duì)自己的身體更加負(fù)起責(zé)任來(lái)。今天許多人正在改變飲食習(xí)慣，人們都吃低脂肪低膽固醇的食物。許多人更加注意減少生活中精神緊張的壓力。美國(guó)現(xiàn)在吸煙的人數(shù)要比20年前少得多，因?yàn)橛性S多人成功地戒掉了這種惡習(xí)，還因?yàn)殚_(kāi)始嘗試吸煙滋味的人也越來(lái)越少。還有越來(lái)越多的人嘗到了像走路、跑步、游泳之類(lèi)的按時(shí)鍛煉的甜頭。有些人開(kāi)始步行或騎自行車(chē)上班而不坐汽車(chē)。數(shù)百萬(wàn)人已經(jīng)成了健身俱樂(lè)部的會(huì)員，這就使健身俱樂(lè)部成為今日美國(guó)發(fā)展最迅速的行業(yè)之一。現(xiàn)在人們對(duì)待健康的態(tài)度的轉(zhuǎn)變，人們行動(dòng)的轉(zhuǎn)變所帶來(lái)的好處已經(jīng)開(kāi)始顯露出來(lái)了：因心臟病致死的病例下降了，這使人們得到很大的鼓舞。