肝膽外科文獻常用英語單詞及高等數(shù)學基本概念、基本公式

文獻生詞malignancy 惡性,惡性腫瘤hepatectomy 肝切除術bilirubin 膽紅素bilirubinemia膽紅素血癥Hyperbilirubinemia 高膽紅素血癥Indocyaninegreen 吲哚花青綠indocyaninegreenretention 靛青綠滯留量試驗hepaticinsufficiency 肝功能不全,肝功能衰退jaundice 黃疸retrospectivereview 回顧性調(diào)查intraoperative 手術中的,術中parameters 參數(shù)LogisticRegression Logistic回歸prognosis 預后prognostic預后的hilar 門的,臍的cholangiocarcinoma 膽管上皮癌intrahepaticcholangiocarcinoma 肝內(nèi)膽管癌anatomic 解剖的,解剖學的hepatichilus肝門perioperative 圍手術期的indication 適應證,指征curative 治愈的resection 切除術likelihood 可能性liverfunction 肝功能metastasis 轉(zhuǎn)移hepatocellularcarcinoma 肝細胞癌unexpected 意外的,忽然的cholestasis膽汁淤積biliarydrainage 膽汁引流extendedhemihepatectomy 擴大半肝切除術Trisegmentectomy 三段切除Chronicviralhepatitis 慢性病毒性肝炎cirrhosis 肝硬化serum 免疫血清,血清onadmission 入院時,住醫(yī)院時percutaneous 經(jīng)皮的transhepatic 經(jīng)肝的endoscopicbiliarydrainage 內(nèi)鏡膽管引流,內(nèi)鏡膽管引流術,endoscopic內(nèi)窺鏡的;內(nèi)窺鏡檢查的drainagetube 引流管,排液管portalvein 門(靜)脈embolization 栓塞,栓塞術,栓子形成peritoneal 腹膜的dissemination 播散,散布laparotomy 剖腹手術distantmetastasis 遠端轉(zhuǎn)移SurgicalProcedures 外科手術anastomosis 吻合術enteric 腸的intermsof 以…的觀點;以…的方式hemorrhage出血hemorrhagic 出血性的hemolysis溶血hemolytic 溶血的hematology血液學hematological 血液的hemodynamics 血流動力學coagulationstatus高凝狀態(tài)prothrombintime 凝血酶原時間activatedpartialthromboplastintime 激活部分促凝血酶原激酶時間antithrombin 抗凝血酶thrombolytic 溶血栓藥,血栓溶解劑duration 持續(xù)時間;期間nonlinearleastsquaresmethod 非線性最小平方法naturallogarithm 自然對數(shù)categorize 分類galactosetolerancetest 半乳糖耐量試驗halflife 半衰期computedtomographyscan 計算機體層攝影掃描,CT掃描contrastmedium 對比劑,造影劑bolus 推注integratedsoftware 集成軟件variables 變量continuousvariable 連續(xù)變量categoricalvariable 分類變量univariate 單變量multivariate多變量univariateanalysis 單變量分析multivariateanalysis 多元分析,多元統(tǒng)計分析stepwiseprocedure 逐步過程chisquaretest χ2檢驗,卡方檢驗,cutoffvalue 截斷值OddsRatio 比值比MannWhitneytest 曼-懷二氏檢驗tailed 有…尾的receiveroperatingcharacteristiccurve 接受者（機）操作特征曲線morbidityandmortality 并發(fā)癥和死亡率decompression減壓inregardto 關于,至于livingrelatedlivertransplantation 活體親屬供肝肝移植術parenchyma 實質(zhì)liverparenchyma 肝實質(zhì)excretory 排泄的,分泌的parenchymal 質(zhì)的,主質(zhì)的shrinkage 皺縮,皺縮度biotransformation 生物轉(zhuǎn)化adenosinetriphosphate 三磷腺苷ammonia 氨AspartateAminotransferase 天冬氨酸氨基轉(zhuǎn)移酶AlanineAminotransferase 丙氨酸氨基轉(zhuǎn)移酶LactateDehydrogenase 乳酸脫氫酶alkalinephosphatase 堿性磷酸酶glutamyl 谷氨?；鵌nferiorVenaCava 下腔靜脈abdominalaorta腹主動脈Paraaortic 主動脈旁的celiacaxis 腹腔干commonhepaticartery 肝總動脈properhepaticartery 肝固有動脈superiormesentericArtery 腸系膜上動脈Hepaticarterythrombosis 肝動脈血栓形成pseudoaneurysm 假性動脈瘤portacavalshunt門(靜脈與)腔靜脈分流術arterialization動脈化angiography 血管造影術occlusion 閉塞梗塞occluded 閉塞的collateral側的,側支,副的confluence 合流,匯流autologousveingraft自體靜脈移植物portahepatis 肝門Portallymphnode 肝門淋巴結secondorderbiliaryradicles 二級膽管根lobaratrophy 肝葉萎縮caudatelobe 尾狀葉falciformligament 肝鐮狀韌帶periampullary 壺腹周圍的Retroduodenal 十二指腸后的jejunum (jejunal) 空腸（的）ileum(ileal)回腸（的）colon(colonic)結腸（的）rectum(rectal)直腸（的）analcanal肛管oncology腫瘤學oncological 腫瘤學的neoplasm腫瘤，新生物neoplastic 腫瘤的，新生物的neoplasticseeding腫瘤播種papillarytumor 乳頭瘤adenocarcinoma 腺癌cystadenoma 囊腺瘤testis 睪丸gastrinoma 胃泌素瘤squamouscellcarcinoma 鱗狀細胞癌carcinoidtumors 類癌sarcoma 肉瘤focalnodularhyperplasia(FNH) 局灶性結節(jié)性增生parenchymaldisease 器質(zhì)性疾病advancedcancer晚期癌癥welldifferentiated 分化良好nodule 結節(jié)nodalmetastases淋巴結轉(zhuǎn)移therapeuticeffect 療效neoadjuvantchemotherapy新輔助化療radiofrequencyablation 射頻消蝕arterialchemoembolization 動脈化療性栓塞infiltrating 浸潤macroscopically 肉眼[檢查]的;目視的carcinoembryonicantigen 癌胚抗原indication適應癥指征contraindication 禁忌證preoperativeworkup術前全面評估postoperativemorbidityrate術后并發(fā)癥發(fā)生率operativeapproach 手術入路radicaloperation 根治術,根治性手術enbloc 整個地,整塊地inoperable 不能手術的,不能做手術的palliative 姑息的diagnosticlaparoscopy 診斷性腹腔鏡檢查non-therapeuticlaparotomy非治療性剖腹探查術invasivetechniques微創(chuàng)技術proceduralcomplications手術并發(fā)癥pancreaticoduodenectomy 胰十二指腸切除術Adrenalectomy 腎上腺切除術thrombectomy 血栓摘除術lymphadenectomy 淋巴結切除術LymphNodeDissection 淋巴結清掃術lymphnodeharvest淋巴結清掃endtosideanastomosis 端側吻合術hepaticojejunostomy 肝空腸吻合術cholecystectomy 膽囊切除術Caudatelobectomy 尾狀葉切除術 radiopharmaceuticalagent 放射性藥劑iodizedoil 碘化油absoluteethanol 無水乙醇scintigraphy 閃爍掃描術helical 螺旋的,螺旋狀,螺旋狀的crosssectionalimaging 橫斷層面成像magneticresonanceimaging(MRI)磁共振成像endoscopyretrogradecholangiopancreatography (ERCP) 內(nèi)鏡下逆行膽胰管造影magneticresonancecholangiopancreatography(MRCP)磁共振胰膽管成像intraoperativeultrasonography 術中超聲檢查法contrastenhancedcomputedtomography對比增強掃描CTpositronemissiontomographyPET正電子發(fā)射斷層掃描cholangiogram 膽管造影Recurrence復發(fā)followup 隨訪concomitant 伴發(fā)的,附隨的comorbidities 并存病bleeding 出血,流血extravasation 外滲,溢出hemobilia 膽道出血biliaryfistula 膽瘺pleuraleffusion 胸腔積液lungedema 肺水腫splenomegaly 脾腫大hypersplenism 脾功能亢進hepaticencephalopathy 肝性腦病ascites 腹水subphrenicabscess 膈下膿腫endotoxaemia 內(nèi)毒素血癥myocardialinfarction 心肌梗死pyrexial 發(fā)熱的hypothermic 低體溫的BiliaryStricture 膽管狹窄steatohepatitis 脂肪性肝炎fattyliver 脂肪肝adiposetissue 脂肪組織primarysclerosingcholangitis 原發(fā)性硬化性膽管炎angina 心絞痛sepsis 敗血癥,膿毒癥perfusion 灌注exvivo 離體,在活體外insitu 原位rightupperquadrant 右上象限proximalpart 近心端perineural神經(jīng)周圍的bifurcation 二根分叉部,分岔ipsilateral 身體的同側的,同側的InstitutionalReviewBoard 機構審查委員會EthicsCommittees 倫理學委員會predisposeto 易患，使易感染、誘發(fā)platelet 血小板hyperalimentation 高營養(yǎng)支持cirrhotic 硬變的morbidity 并發(fā)癥，發(fā)病率medications 用藥dislodge 移去,逐出,取出gonadal 性腺的,生殖腺的Histologic 組織學的frozensection 冰凍切片atrophy 萎縮hypertrophy 肥大,過度生長proliferation 增生,增殖hyperplasia 增生;數(shù)量性肥大Stemcells 干細胞bonemarrowderived 骨髓衍生的epithelium 上皮,上皮細胞encased 包裹reconstruction 重建,再造,重構inflammatory 炎癥性的broadspectrumantibiotics 廣譜抗菌素bloodculture 血培養(yǎng)GramNegativebacillus 革蘭陰性[芽胞]桿菌cutsurface 切面stent 支架catheter 導管directcannulation 直接插管spectrophotometer 分光光度計rupture破裂,vt.(使)破裂somatostatin 生長抑素ExtracellularMatrix 細胞外基質(zhì)cohort 同期組群LengthofStay 住院時間afterdischarge出院后stratified 分層的,成層的clearcut明確的Inthisregard在這方面comeatacost是有代價的progressively 進行性地,漸進地rationale 原理,基礎理論homogeneous同類的同質(zhì)的heterogeneous異類的,不同的putative 假定的omnipotent 全能的,無所不能的ascontrols作為對照preconditioned預處理preconditioning預處理prospectively前瞻性prospectiverandomizeddate前瞻性隨機數(shù)據(jù)Disease-Specificsurvival疾病特異性生存率irreversible 不可逆的references 參考Cochrane 循證醫(yī)學cholangiopancreatography 胰膽管造影術resolution 分辨率（決心，決議解決）herein 如此,鑒于，在此處iatrogenic 醫(yī)源性palliation 緩和,減輕runningsuture 連續(xù)縫合orthotopiclivertransplantation 原位肝移植chemoradiation 放化療preneoplasticchange 癌前變化carcinogenesis 致癌作用dysplasia 發(fā)育不良,不典型增生endoprosthesis 內(nèi)鏡置管術pruritus 瘙癢pruritis 瘙癢癥Etiology(aetiology)病原學etiologic 病原學的epidemiology流行病學epidemiological 流行病學的pathophysiology 病理生理學lesion病變Radionuclide 放射性核素nitrosamine 亞硝胺類pathogenesis 發(fā)病機制carcinoid 類癌MucinousAdenocarcinoma 粘液腺癌Clearcelladenocarcinoma 透明細胞腺癌Signetringcelladenocarcinoma 印戒細胞腺癌AdenosquamousCarcinoma 腺鱗狀癌SquamousCellCarcinoma 鱗狀細胞癌OatCellCarcinoma 燕麥細胞癌UndifferentiatedCarcinoma 未分化癌Papillomatosis 乳頭狀瘤病PapillaryCarcinoma 乳頭狀癌hepatoblastoma 肝母細胞瘤Haemangioendothelioma 血管內(nèi)皮瘤neuroendocrinetumour 神經(jīng)內(nèi)分泌瘤Leiomyosarcoma 平滑肌肉瘤malignantfibroushistiocytoma 惡化纖維組織細胞瘤nodulartumors結節(jié)性腫瘤cachexia 惡液質(zhì)sterilize 滅菌,消毒surgicalradicality手術的根治性angiogenetic血管生成angiogenic血管源性的，生成血管的antiangiogenic 抗血管生成的chemosensitization化療增敏photosensitizer 感光劑,光敏劑irradiation 放射，照射conformationalradiotherapy適形放射治療brachytherapy 短距離放射治療stereotactic 立體定位的,立體定向的interventionalradiology 介入放射學oxaliplatin 奧沙利鉑doxorubicin 多柔比星gemcitabine 吉西他濱immunosuppressant 免疫抑制劑Portography 門靜脈造影術contrastagent 對比劑,造影劑lipiodol 碘油Iodophor碘伏cysticduct 膽囊管choledochalduct 膽總管choledochalcysts 膽總管囊腫Choledocholithiasis 膽總管結石hepatolithiasis 肝內(nèi)膽管結石病orientalcholangiohepatitis 東方人膽管肝炎Biliarymalformation 膽管畸形Liverfluke 肝吸蟲protocol 治療方案therapeuticregimen 治療方案PalliativeTreatment 姑息治療SignsandSymptoms 體征和癥狀plethora 多血癥,多血質(zhì)DifferentialDiagnosis 鑒別診斷RandomizedControlledTrials 隨機對照試驗enterocinesia 腸動,腸蠕動Ligation 結扎術luminalobstruction官腔阻塞screening 普檢,篩查,篩選predisposingfactor 易感因素enhancedsusceptibility 增強易感性hyperbaricoxygentreatment 高壓氧治療asymptomatic 無癥狀的indolent 無痛的IntractablePain 頑固性疼痛visceral 內(nèi)臟的steatosis 脂肪變性latency 潛伏期sideeffects 副作用decompensation 失代償anoxia 缺養(yǎng)癥anoxic 缺氧的anoxemia.缺氧血癥;血缺氧ischemia 局部缺血,缺血Ischemia-ReperfusionInjury 缺血再灌注損傷ischemicchange 缺血性改變anemia 貧血pyogenic 化膿的purulent 化膿性,膿性的hepatomegaly 肝腫大umbilicalfissure 裂臍cytokine 細胞因子neuropeptide 神經(jīng)肽neurotransmitter 神經(jīng)遞質(zhì)fluorescenceinsituhybridization 熒光原位雜交necrosis 壞死necrocytosis 細胞壞死apoptosis凋亡apoptotic 細胞凋亡的desmoplasticreaction 纖維成形性反應oncogene 癌基因SuppressorGenes 抑制基因genetic 遺傳的epigeneticchange 基因外改變hypermethylation 超甲基化sequentialoccurrence 順序發(fā)生stepwise 分步的,分段的,逐步的mesenchymal 間質(zhì)morphology 形態(tài)atypia 非典型,異型性Phenotype 表型dehydration 脫水paraffin 石蠟impregnation 浸漬,受精,受孕embedding 包埋,埋植serialsection 連續(xù)切片anesthesia 麻醉anesthesiology麻醉學anesthetist麻醉師palpation 觸診orifice 管口,口,小孔oneorifice 一個管口intubate 插管 pancreaticsecretion 胰腋centrifuge 離心,,離心機cannulation 管子reactiveoxygenspecies 活性氧recanalization 再通，再穿通CeliacPlexus 腹腔叢arteriolar 微動脈的,小動脈的CollateralCirculation 側支循環(huán)intima內(nèi)膜subintimal 內(nèi)膜下的mitochondria 線粒體multifocal 多病灶的endemic 地方性的amenable 適合的morespecifically 更具體地說mainstay 主要依據(jù)kink 扭折,紐結lethal 致命的peculiarity 特性armamentarium 醫(yī)療設備,設備demarcate 劃界線,分開,區(qū)別paucity 資料貧乏migration 移位interimreport 中期報告nihilistic 虛無主義的enigmatic 難理解的，神秘的occult 隱匿的，潛隱的autopsy 尸檢detritus 腐屑,腐質(zhì),碎屑antegrade 順行的retrograde逆行的endogenous 內(nèi)源的,內(nèi)生的exogenous 外源的,外生的intracorporeal體內(nèi)的extracorporeal 體外的autocrine 自分泌paracrine 旁分泌xenogenic 異體的,異種的cryptogenic 隱原性的,原因不明的insidiously 隱襲地congenital 先天的,天生的hereditary 遺傳的,遺傳性的pitfall 缺陷Biliaryanomalies 膽道畸形cholecystolithiasis膽囊結石cholecystitis 膽囊炎choledocholithiasis 膽總管結石totalbilirubin總膽紅素unconjugatedbilirubin游離膽紅素conjugatedbilirubin 結合膽紅素bileplug 膽栓sinusoid血竇，竇狀隙sinusoidal血竇的竇狀隙的transjugular 經(jīng)頸靜脈的portosystemicshunt 門體分流術hepaticcoma 肝昏迷hyperammonaemia 高氨血癥hypoalbuminemia 低白蛋白血癥neuropsychiatric 神經(jīng)精神性的confusion 意識錯亂,意識模糊disorientation 定向障礙astrocyte 星形膠質(zhì)細胞inflammatorymediator 炎癥介質(zhì)neutrophil (neutrophilicgranulocyte) 嗜中性粒細胞macrophage 巨噬細胞phagocyte吞噬細胞phagocytosis 吞噬作用mitogen 促細胞分裂原,有絲分裂原reticuloendothelialsystem 網(wǎng)狀內(nèi)皮系統(tǒng)Synthase 合酶dysregulation 調(diào)節(jié)異常,失調(diào)chromosome 染色體nuclearatypia 核異型nucleotide 核苷酸mitochondria線粒體mitochondrial 線粒體的microsome微粒體microsomal 微粒體的detoxify去毒,解毒，戒煙毒detoxification 解毒(作用),脫毒,戒毒治療carcinogen 致癌物mutagen 誘變劑,致突變原carbohydrateantigen 糖類抗原標志物,糖鏈抗原glycoprotein 糖蛋白extirpation 摘除malignanttransformation 惡變,惡性轉(zhuǎn)化forcepsbiopsy 鉗夾活檢,鉗夾活檢術transpapillary 經(jīng)十二指腸乳頭stenosis 狹窄stenotic 狹窄的patencyrate 通暢率vasculature 脈管系統(tǒng)diffuseintravascularcoagulation彌散性血管內(nèi)凝血(DIC)coagulantandfibrinolyticsystems凝血和纖溶系統(tǒng)circulatorydisturbance循環(huán)紊亂VascularPermeability 血管通透性vasodilatation 血管擴張vasopressor 血管升壓類藥物vasopressin 加壓素endothelin 內(nèi)皮縮血管肽prostaglandin 前列腺素SaphenousVeins 隱靜脈renin 腎素angiotensin血管緊張素aldosterone 醛固酮oestrogen (estrin) 雌激素progestogen(progestin)孕激素androgen(androtin)雄激素testosterone 睪酮acutetubularnecrosis 急性腎小管壞死oedema 水腫oliguria 少尿癥diuretic(a) 利尿劑haemofiltration 血液濾過dialyse 透析dialysate (DialysisSolutions)透析液acuterespiratorydistresssyndrome急性呼吸窘迫綜合征(ARDS)diaphragm橫隔dyspnea 呼吸困難pulmonaryoedema肺水腫ventilatorydysfunction通氣功能障礙TotalParenteralNutrition 全胃腸外營養(yǎng)enteralnutrition 腸道營養(yǎng)malabsorption 吸收不良venoplasty血管成形術hematoma血腫 perforation穿孔paracentesis 穿刺,穿刺術granulomatousinflammation 肉芽腫性炎癥BacterialTranslocation 細菌移位theadministrationofantibiotics抗生素的應用prophylacticantibiotics 預防性抗生素synbiotictherapy合生元治療freeradical 自由基lactate 乳酸鹽malaise 不適感,全身乏力episode 發(fā)作idiopathic 特發(fā)性的,自發(fā)性的tracer 示蹤劑relaparotomy 再手術mildtomoderate 輕度到中度multifactorial 多因子的,多因素的iohexol 碘海醇procaine普魯卡因lidocaine 利多卡因analgesia鎮(zhèn)痛dehiscence 裂開cryopreserved 冷藏保存的discriminantanalysis 判別分析cadaveric 尸體的subjects 受試者obliteration 涂去,抹消,刪除milieu 環(huán)境,境界potent 有力的,有效的schematicdiagram 示意圖,原理圖misidentification 錯誤認同,錯認algorithm 公式,算法,推導strongecho強回聲acousticshadow聲影hyperecho(ic)高回聲（的）isoecho(ic)等回聲（的）hypoecho(ic)低回聲（的）anecho(ic)無回聲（的）aseptictechnique無菌術asepsis滅菌antisepsis消毒emergencyoperation急診手術confineoperation限期手術selectiveoperation擇期手術evidence-basedmedicine循證醫(yī)學polymerasechainreaction(PCR)聚合酶鏈反應inquiry問診chiefcomplaints主訴historycollection病史采集historyofpresentillness現(xiàn)病史pasthistory既往史personalhistory個人史maritalhistory婚姻史menstrualhistory月經(jīng)史childbearinghistory生育史familyhistory家族史physicalexamination體格檢查inspection視診palpation觸診percussion叩診auscultation聽診abdominalpain腹痛abdominaldistension腹脹diarrhea腹瀉constipation便秘nausea惡心vomit嘔吐stool大便urine小便aspiration誤吸asphyxia(apnea)窒息atelectasis肺不張arrhythmia心律失常cardiacarrest心臟驟停ventricularfibrillation心室纖顫hyperthermia高熱hypothermia低溫Natrium(sodium)鈉Kalium(potassium)鉀Chlorine氯Calcium鈣Magnesium鎂Phosphorus磷ion離子homoeostasis 體內(nèi)平衡derangement 紊亂isotonicdehydration等滲性缺水hypotonicdehydration低滲性缺水hypertonicdehydration高滲性缺水waterintoxication水中毒hyponatremia 低鈉血癥hypernatremia 高鈉血癥hypochloremia低氯血癥hyperchloremia高氯血癥hypokalemia低鉀血癥hyperkalemia高鉀血癥hypocalcemia低鈣血癥hypercalcemia高鈣血癥hypomagnesemia低鎂血癥hypermagnesemia高鎂血癥hypophosphatemia低磷血癥hyperphosphatemia高磷血癥metabolicacidosis代謝性酸中毒metabolicalkalosis代謝性堿中毒respiratoryacidosis呼吸性酸中毒respiratoryalkalosis呼吸性堿中毒hematocrit(Hct)血細胞比容autologousbloodtransfusion自體輸血salvagedautotransfusion回收式自體輸血predepositedautotransfusion預存式自體輸血hemodilutedautotransfusion稀釋式自體輸血cryoprecipitate冷沉淀furuncle癤furunculosis癤病carbuncle癰acutelymphangitis急性淋巴管炎erysipelas丹毒abscess膿腫dermoidcancer皮膚癌melanotic黑痣melanoma黑色素瘤lipoma脂肪瘤neurinoma神經(jīng)鞘瘤neurofibroma神經(jīng)纖維瘤capillaryhemangioma毛細血管瘤angiocavernoma海綿狀血管瘤racemosumhemangioma蔓狀血管瘤sebumcyst皮脂腺囊腫tetanus破傷風gangrene壞疽superinfection二重感染septicemia敗血癥debridement清創(chuàng)術simplegoiter單純性甲狀腺腫hyperthyroidism甲亢hypothyroidism甲減mastitis乳腺炎mastopathy乳腺病，乳腺增生癥mastectomy乳房切除術teratoma畸胎瘤inguinalhernia腹股溝疝femoralhernia股疝incisionalhernia切口疝umbilialhernia臍疝herniaoflineaalba白線疝interloopabscess腸間膿腫helicobacterpylory(HP)幽門螺桿菌pyloricobstruction幽門梗阻vagotomy迷走神經(jīng)切斷術lymphoma淋巴瘤duodenaldiverticulum十二指腸憩室intussusception腸套疊polyps息肉ulcerativecolitis潰瘍性結腸炎rectalprolapse直腸脫垂anorectalabscess直腸肛管周圍膿腫analfistula肛瘺analfissure肛裂haemorrhoids痔internalhaemorrhoids內(nèi)痔externalhaemorrhoids外痔mixedhaemorrhoids混合痔annulushaemorrhoids環(huán)形痔proctocolectomy 直腸與結腸切除術majoroperation 大手術omentum 網(wǎng)膜pancreaticobiliary 胰膽管的Bilecanaliculus 膽小管mediastinum 縱隔quadratelobe 方葉organic 有機的,器官的interferon 干擾素glomerularfiltrationrate 腎小球濾過率FulminantLiverFailure 暴發(fā)性肝衰竭NephroticSyndrome 腎病綜合征enteropathy 腸病,腸病變Esophagealcancer 食管癌gastroesophagealvarices 胃食管靜脈曲張SupinePosition 仰臥位informedconsent