第六十三章 凌晨五点(5月12日2/2(1 / 2)
我能看见状态栏
罗三观.CS
1073 字
2022-04-26
重症菌痢,这要比普通痢疾棘手多了。
负责接诊患者的是一名刚升主治不久的年轻男医生。孙立恩以前和他见过几面,对对方的了解仅限于知道他叫王宝和而已。
“王医生。”孙立恩很客气的和王宝和点了点头,然后拿起了病例开始翻看。一边看一边顺带朝着患者的脑袋上扫了一眼。
“林正,男,27岁。细菌性痢疾(28.33.42),轻微脓毒症(08.12.37),中度脱水(06.51.23),失禁(01.00.51)”
“立恩,你对这个患者有兴趣?”王宝和对这样的患者是有些发憷的。倒不是因为细菌性痢疾有多可怕,主要是因为这种重症菌痢患者往往都有失禁的症状。再加上排泄物中多有脓血甚至坏死脱落的肠粘膜,患者会持续在脱水和脓毒症甚至营养不良的拖累下快速恶化。总而言之,又脏又难治。
“我就是过来看看。”孙立恩朝着王医生笑了笑,“毕竟是给曹哥洗过头的狠角色嘛……”
王医生给林正的治疗是标准流程,通过平衡液补充失去的水分,利用抗生素对抗细菌感染,并且还吊了一瓶葡萄糖用于调整患者血糖。毫无差错的应对举措——当然了,堂堂第四中心医院急诊科的医生,要是连个重症细菌性痢疾都不知道该怎么处理,那四院还是关门算了。
“志贺杆菌对喹诺酮类抗生素有抗药性吧?”孙立恩看完了整体治疗方案之后,谨慎的提出了自己的意见,“用头孢曲松或者阿米卡星不是更好一点么?”
“患者有头孢过敏史,阿米卡星在患者脱水的时候需要谨慎使用。”王宝和把孙立恩的质疑当做了规培医生的求教,他回答的倒是非常耐心,“现在主要还是给他补水扩容,等他的排尿量恢复到正常水平之后,我准备再换成阿米卡星——现在给他用的氧氟沙星是喹诺酮类抗生素里,出现抗药性概率最低的一种。”
孙立恩点了点头,“不用给他做降温处理么?”
“三十八度四的水平暂时还不用。退烧药能让他稍微好受一点,但是口服药物现在不一定好吸收——他拉的太严重了。赖氨匹林注射剂之类的会导致消化道出血,对这种重症细菌性痢疾的患者来说还是能免则免。”王宝和打了个哈欠,“小孙你不困么?”
“我啊?”孙立恩眨了眨眼睛,时间已经到了凌晨五点,他早就过了最困的时候。“困过劲了……”
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