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医案分析-连续73小时游戏导致的猝死 – 译学馆
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医案分析-连续73小时游戏导致的猝死

A Man Played Video Games Nonstop For 73 Hours. This Is How His Organs Shut Down.

A man, played video games non-stop for 73 hours.
一位男性 连着玩了73小时电子游戏
This is how his organs shut down.
他的器官是这样衰竭的
DC is a 25 year old man,
DC 是一位25岁的男性
presenting to the emergency room, dead on arrival.
被送到急诊室时已经宣告临床死亡
Paramedics were desperately performing chest compressions to try
医务人员拼命地对他进行胸外按压
and push blood back into his brain.
试图让血液泵入大脑
To try and push blood into his organs.
并泵入体内器官
To try to keep him alive.
努力让他活下来
But it seemed like their attempts, were all in vain.
但似乎他们所做的努力 都是白费的
DC was a college graduate, but he never wanted to go to school.
DC 是个大学毕业生 但他无心从学
He worked a minimum wage job, but he was recently fired.
之前拿着最微薄的薪水 但最近被炒了鱿鱼
He wanted to be an internet video game streamer, but no one was watching.
他一心想成为游戏主播 但并没有多少观众
And he lived at home with his mom where she still cooked for him,
他还住在家里 有母亲为他做饭
but she kicked him out when he was no longer going out to look for a new job.
由于DC不再出去找工作 母亲把他赶出了家门
Depressed and lost, DC binged on video games
失意且迷茫的DC开始沉迷电子游戏
at the local internet cafe for days at a time.
在当地的网吧一玩就是很多天
Sometimes he’d sleep at the computer,
有时他干脆在电脑前睡觉
and wake up to play some more.
醒来继续玩
He gave up personal hygiene.
他不再注意个人卫生
He gave up friendships.
不再关注朋友们
His life was games.
游戏就是他的生命
He was obsessed, and he just couldn’t stop playing.
他沉迷于游戏 无法自拔
One weekend, DC played for 73 hours, nonstop.
一个周末 DC连续打了73小时的游戏
Glued to his seat, he barely ate any food.
一直没离开过椅子 几乎不吃东西
He hardly drank any water. He didn’t even get up to use the bathroom,
他几乎不喝水 甚至不愿起身去洗手间
having already released a few times in-between,
即使原地小便也在所不惜
and finally couldn’t hold it in anymore.
最后他再也忍不住了
He got up for the first time in days
这么多天以来
as he stood up from his chair. He suddenly felt lightheaded.
他第一次从椅子上站起来 突然觉得头晕
He blacked out. And then instantly collapsed.
眼前一黑 随后就晕倒在地
At the front desk of the internet cafe,
在网吧的前台
the owner was oblivious to the fact that someone had fainted on his property.
老板对于自己店里有人晕倒浑然不知
30 minutes pass and DC was found on the floor,
30分钟后 有人发现DC倒在地上
unconscious and struggling to breathe.
失去意识且呼吸困难
911 is called.
有人拨打了911
In the ambulance, DC suddenly flatlines.
在救护车里 DC突然没了心跳
His heart stops beating and he stops breathing.
他的心脏不再跳动 他也停止了呼吸
Paramedics desperately begin CPR
医护人员赶紧对他进行心肺复苏
as he’s brought to the emergency room where we are
他也被送进了我们现在所在的急诊室
now. Doctors continue chest compressions.
医生继续对他进行胸外按压
Ultrasound immediately reveals that the right side of his heart is swollen.
超声检查立刻发现了他心脏右侧肿了起来
It’s larger than the left ventricle, which is the part of the heart that’s responsible
它比左心室大得多
for pumping blood to the entire body.
而左心室是负责将血液泵到身体各部位的
The left ventricle has more muscle
左心室肌肉更为发达
so it’s largest part of the heart in every normal functioning human.
因此是正常人的心脏中最大的部分
But DC can’t function normally now.
但DC目前并不正常
His heart is twisted.
他的心脏扭成了一团
It’s disfigured.
它变形了
This immediately tells the medical team
医护人员立刻判断出
that he’s suffering from Acute Massive Pulmonary Embolism.
他有急性大面积肺栓塞
Embolus from Ancient Greek meaning a wedge,
Embolus源于古希腊语 意为楔子
or in this case referring to a blood clot.
这里是指血栓
Pulmonary meaning Lung.
Pulmonary意为肺部
And Massive referring not to size
Massive不是指实际血块的大小
of the actual clot but to the SUDDEN hemodynamic collapse that it caused in DC.
而是DC体内突发的大规模血流动力学衰竭
A blood clot wedged into the lungs causing his heart to disfigure.
血栓堵在了肺动脉 导致了心脏变形
Causing his heart to stop beating because it is disfigured.
而心脏变形则是心脏骤停的原因
Causing his organs to shut down because they’re no longer receiving oxygen due to the fact
而心脏停搏则导致器官供氧停止
his heart has stopped beating.
最终导致器官衰竭
Acute meaning that he didn’t have any underlying medical issues leading to this problem, except
Acute意味着他并没有任何潜在的医疗问题诱因
for sitting at a computer playing video games nonstop for 73 hours.
除了枯坐在电脑前连着打了73小时电子游戏
Doing anything nonstop for 70 hours is dangerous,
不管做什么 持续70小时都很危险
but sitting down nonstop for 70 hours is deadly,
但是由于静脉瘀血
because of venous stasis.
70小时坐着不动可以致命
This is a time when a lack of movement of the legs causes blood to pool.
当腿部不再运动 血液就开始积聚
The blood pressure in the body’s veins is already low because there isn’t anything
静脉血压本来就低
directly pumping it back to the heart.
因为静脉没有东西直接把血泵回心脏
Venous blood oozes its way back.
所以静脉血缓慢地流回心脏
Without moving the legs for 70 hours and given
腿部70个小时没有运动
that sitting down compresses the veins, a
加上一直坐着会压迫静脉
compartment of the body where blood flow is already slower than normal, then this pooling
那么身体某处血流已经比正常流速慢
of blood causes some of it to clump together
然后积聚的血液使其中一部分聚集在一起
into a clot, called a deep vein thrombosis,
形成血栓 被称为深静脉血栓
which is what happened to DC as he sat there,
这就是DC那数天坐着不动 体内所发生的变化
for days, but there’s more.
但事情不止如此
As the clot formed,
随着血栓形成
it stayed in his legs for as long as he was sitting down.
只要他坐着 血栓就一直积聚在腿部
He got up, it broke off,
他站起来 血栓就脱落
it went directly into the right side of his heart like how blood normally does,
并像正常血流般直接流入了右心室
but then lodged itself directly into the pulmonary artery where the
但随后血栓直接堵住了肺动脉
right side of the heart connects to the lungs.
即右心室和肺连接的血管
This back up of blood into the right ventricle, caused it to stretch.
而流回右心室的血 导致右心拉伸
To distend. To disfigure.
扩张 变形
But this is only the beginning of the dysfunction.
但这只是心肌功能障碍的开始
The right ventricle of the heart typically has a thinner wall than the left.
右心室壁通常比左心室壁薄
It has a lower volume to surface area ratio.
其容量表面积较低
This makes sense because blood from here goes directly to the lungs.
这很正常 因为血液直接从这里流入肺部
You don’t need high pressure going to the lungs when they are right there.
肺就在旁边 不需要高压推动血流入肺
But when the right ventricle swells due to flow backing up,
但当右心室因血液回流而肿胀
wall stress increases.
室壁压力升高
It pushes against the interventricular septum,
血压推向室间隔
causing it to bow out into the left ventricle.
使之偏向左心室
This increased pressure and volume in the right displaces the left,
右心的压力和容量增大 取代左心
reducing cardiac output.
降低了血液输出量
In DC’s case
在DC的病例中
of hemodynamic collapse secondary to massive pulmonary embolism, an occlusion
血流动力学衰竭是继发于大面积肺栓塞
into the pulmonary artery meant a filling defect
肺动脉的闭塞意味着左心室充盈缺损
on the left as blood can not be pumped out to the rest of the body.
因为血液无法泵向身体其他部分
There is no longer an adequate oxygen supply
身体里再也得不到足够氧气
in his body as his organs all start to die.
因此各器官开始衰竭
His heart, while still trying to beat, can no longer function.
他的心脏虽仍努力想跳起来 但再也不能工作了
It arrests, as he comes into the emergency room, without a pulse.
心脏就此停搏 当他被送进急诊室时已经没有了脉搏
But it wasn’t like this when they found him.
但他们最初发现DC的时候并不是这样
Paramedics tell the medical team that DC was found gasping for air.
医护人员告诉医疗组 当时他还在喘着
That he did have a heartbeat when they found him,
实际上他当时还有心跳
but it was fast, from his body detecting hypoxemia,
不过他当时心跳很快 因为他的身体检测出低氧血症
a low oxygen presence in blood.
即血液中氧气含量低
His blood pressure was low from the then hemodynamic compromise.
由于血液动力学衰竭 他的血压降低
And that it was on the way to the emergency room
并在送去急诊室的途中
that his heart suddenly stopped beating.
出现了心脏骤停
That all of this happened just minutes ago,
这一切仅仅发生在几分钟之前
meaning that it might not yet be too late.
意味着这也许不算太晚
There might still be a chance to bring DC back to life.
也许还有机会把DC抢救过来
Is there a way, we can somehow remove the clot from DC’s lungs?
是否有方法 让我们以某种方式移除DC肺部的血块呢
Maybe.
可能有
But it has to be done, immediately.
但这必须马上实施
Surgery and cutting him open to pull it out,
通过手术将肺部切开取出
isn’t an option because it would take too long.
并不可行 这太耗时了
Guiding a catheter through his veins to direct medicine that can dissolve the clot directly,
通过静脉插管 注入可溶解血块的药物
is also not an option because of time.
也不行 因为时间仍然不够
The quickest solution, is to infuse that medicine directly into his entire body.
最快的解决办法是将药物直接注射到全身
This systemic fibrinolytic therapy, is his last hope.
全身纤溶疗法是他最后的希望
On the emergency room bed,
在急诊室的病床上
DC is immediately infused with a large bolus dose of lytic as
医生立刻给DC注射了大剂量的溶栓药
chest compressions are continued.
并持续对其进行胸外按压
Additional lytic was set for infusion over time
继续点滴注入剩下的药物
as this aggressive dosing means the medical team will continue CPR
而大剂量则意味着医疗团队要持续给DC做心肺复苏
until he either comes back to life,
直到他要么死而复生
or it is absolutely certain that DC is lost.
要么确定死亡
As the chest compressions are desperately applied, minutes pass.
随着猛烈的胸外按压 时间一分一秒过去
A detectable heart beat is found
医疗团队检测到了他的心跳
and this return of spontaneous circulation is a good sign.
而这种自发循环复苏是个好兆头
DC is not lost.
DC还有救
But several hours pass, and he doesn’t regain consciousness.
但数小时过去了 他仍未恢复意识
Admission into the intensive care unit finds that he is missing cognitive factors.
入住重症监护病房后 他认知逐渐模糊
Shining a light into his eyes,
光照入眼
a normal functioning human will exhibit a pupillary reflex, where
正常人会表现出瞳孔反射
the pupils will constrict in reaction to the increased presence of light.
瞳孔会在光照增强后收缩
Absence of this indicates brain damage, and in DC, it’s absent.
缺乏这种反应则表明大脑受损 而DC身上就是如此
In a normal functioning human, motor response to pain is natural reflex.
对正常人而言 对痛觉产生运动反射是一种自然反应
Absence of this reflex indicates brain damage, and in DC, it’s absent.
缺乏这种反射同样意味着大脑损伤 而DC身上仍然如此
As the days go by,
几天过去了
DC’s mother arrives to the hospital to see her son.
DC 的母亲来医院看望他
She tries to speak to him but no response.
她尝试和他讲话 但没有得到回应
He may not have listened to her in life,
DC也许一辈子没听过她的话
but the only thing she would like to see now is
但她现在想要的只是一个回应
a response, an indication, something,
哪怕是一个暗示性的回应也好
from her son that tells her he can hear her, but
这样就能让她知道他还能听见她说话
nothing is returned.
但没有任何反应
The several minutes where DC’s body
由于血栓阻塞了心脏和肺的连接点
was not receiving oxygen because of a clot blocking the point where his heart and lungs connected,
这几分钟里DC的身体没有氧气供应
caused this permanent anoxic ischemic damage.
从而导致了永久性缺氧缺血性损伤
Most people can easily pick out that
大部分人能轻而易举地明白
healthy individuals can’t stay up and play games
一个正常人是不能连续三天熬夜打游戏的
for 3 days straight, without sleep, without going to the bathroom.
尤其是在连厕所也不上的情况下
Most people can’t stay up 3 days straight for anything.
无论什么情况 绝大部分人都不能三天不睡
That to be able to play that much means that that person, has a problem.
如果出现了这种情况 就意味着这个人有问题
Internet gaming disorder has been described
连续几年 游戏障碍已经被描述成一种
as a condition for needing further research for several years now.
“需更进一步研究”的健康状况
Back in 2013,
早在2013年
The Diagnostic and Statistical Manual of Mental Disorders, revision 5
这种表述出现在
put that description on paper.
《精神疾患诊断统计手册》(第5版)上
And in 2018, the World Health Organization placed gaming disorder
2018年 在《国际疾病分类》(第11版)中
as a diagnosable condition in the 11th revision
世界卫生组织将游戏障碍
of the International Classification of Diseases.
界定为一种可诊断的病历状况
DC is at one extreme end of the spectrum of what can be described as internet gaming disorder.
DC 的程度已经极端到可以被称为网络游戏障碍了
The actual people who will have this are a small subset
实际上 能走到这一步的人只是一小部分
of the population, because, most people won’t have this level of obsessive behavior. Context here matters, make no mistake.
大部分人并不会有这种程度的强迫症
People who only hear headlines may be underinformed as to what internet gaming disorder really is.
那些只热衷于新闻头条的人可能会对“网络游戏障碍”
What behavior those words are describing. It’s probably not describing a kid
产生误解 从而不清楚这究竟是什么
who wants to play games with his friends after school,
这并非在描述一个放学后想和朋友打游戏的孩子
who day dreams about the game during class,
他可能在课上幻想着玩游戏
but is a functional person who is OK if they don’t play games for a few days.
但几天不打游戏对一个正常人来说没什么问题
Who can comply with their responsibilities.
他知道自己在做什么
It also probably doesn’t describe a 25 year old who plays 20 hours total on the weekend,
也不是描述一个25岁的人周末总共打了20小时的游戏
but can still show up to work during the week,
但仍能在工作日去上班
hold a relationship and family obligations without problem.
在保持家庭关系上没有出现问题
Internet gaming disorder doesn’t describe these people. But,
网络游戏障碍不是来形容这些人的
if someone lets their kids or pets starve to death
但如果有人过于沉迷电子游戏
because they were too focused on playing a game,
令他的宠物甚至是孩子饿死在家里时
then something might be wrong.
这就有问题了
If someone continues to obsessively play
如果一个人被父母赶出家门后
after getting forcibly kicked out their parents ’ house,
仍沉迷于玩游戏
plays for several days at a time nonstop,
而且是连续几天不停地玩
not getting up, not eating, not using the bathroom, and not sleeping,
从不起身 吃饭 上厕所 睡觉
well then something could be wrong.
那么他很可能有问题
Even worse if blood pools in the legs
更糟的是 如果血液因为一个人玩游戏时间太长
while that person is playing,
而聚集在他大腿中
forming a deep vein thrombosis,
形成深静脉血栓 那么最终会形成大面积肺栓塞
that became a massive pulmonary embolism, with end organ malperfusion and
伴随着靶器官灌注不良和血流动力学衰竭
hemodynamic collapse resulting in residual organ dysfunction and hypoxic brain damage.
导致剩余器官功能障碍和缺氧性脑损伤
Something that results in tangible, detrimental and life-threatening consequences due to one’s
由于缺乏对玩电子游戏的自制
lack of self control over playing video games,
从而导致实际有害的 甚至危及生命的后果
IS a problem,
的确是一个需要重视的问题
and it’s a good thing that it’s been classified as such.
我们能把它如此归类的确是件好事
For DC, limited neurocognitive function was recovered
对DC而言 在重症监护室期间
as he suffered from rounds of pneumonia
由于肺炎和脓毒症发作
and sepsis during his stay in the intensive care unit.
神经认知功能的恢复有限
Diminished urine output and elevated transaminase levels
尿量减少和转氨酶水平升高
indicated kidney and liver damage.
则表明肾脏和肝脏受损
The loss of pupillary reflex and
入院后 瞳孔反射
absent extensor motor response days after admission were 100
和伸肌运动反射消失是特异性因素
percent specific factors to indicate poor outcome following anoxic injury, secondary
表明继发于大面积肺栓塞的
to massive pulmonary embolism.
缺氧损伤的不良后果
At autopsy,
在尸检时
extensive neuronal damage was found in the parieto-occipital-temporal cortex of his brain.
DC大脑顶枕颞皮层发现了广泛的神经损伤
Cerebellar injury was observed along with losses at the thalamic nuclei.
观察到小脑损伤伴随丘脑核受损
Little could be done by the time he was found unresponsive at the internet cafe as too much
当他在网吧里被发现无反应时已经回天乏术了
time had passed in a setting where minutes and seconds matter.
因为他已经在这个分秒必争的阶段失去了太多时间
The only hope was to salvage whatever the medical team could,
一旦DC心脏骤停
once DC fell into cardiac arrest.
唯一的希望就是医疗组尽可能的抢救
For gamers today,
对于现在的玩家来说
be sure to keep yourself hydrated
一定要多喝水
and don’t sit for more than an hour at a time.
一次最好不要久坐超过 1小时
Get up, walk around even if just for a couple of minutes.
站起来四处走走 哪怕只走几分钟
And most importantly, be kind to yourself.
最重要的是 善待自己
Internet gaming is actually stressful, even if it’s fun.
实际上即使网络游戏很有趣 它也让人神经紧张
Thank you so much for watching.
谢谢观看
Take care of yourself.
照顾好自己 保持健康

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译制信息
视频概述

一名以毕业却沉迷电子游戏的男生,在连续打了73个小时游戏后,经抢救无效身亡。作为网络游戏障碍的极端病例,他的故事警示喜欢打游戏的人们要注意自己的身体健康。

听录译者

收集自网络

翻译译者

Shea

审核员

审核员1024

视频来源

https://www.youtube.com/watch?v=VY-k_YVkRKs

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