27让人琢磨不透的发展方向求收藏求推荐(1 / 2)
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下午两点多,颅内感染病人的脑脊液报告出来了。
由于隔离区是临时建成的,电脑和整座医院并不联网,检查报告没法第一时间传到他们的电脑里。
陈霄只能靠电话和里面联系得到报告数据:“你说都正常?不可能吧。”
他虽然嘴上不说,但心里很认同祁镜的判断。再加上之后检查病人有颈项强直,就算没有其他脑膜刺激症,单单这一项也基本可以确定是脑炎了。
但说颅内感染的病人,脑脊液数据全部正常,说出去谁听了都不会信的。
就连祁镜在旁看着书,听到这个内容也是大吃一惊。
陈霄知道在传染病方面没法和祁镜相比,连忙打开了免提:“具体报告都说一下,压力、白细胞、糖、氯、蛋白,对了,还有体温!”
“压力160,白细胞0.01,糖2.3,氯120,蛋白0.4,涂片细胞99%分叶核。”
电话那头顿了顿,传来了一连串纸张翻阅的声音,然后继续说道:“体温十分钟前刚测的,依然正常,36.5度,你们确定这人是脑炎?脑脊液报告太正常了,一点都不像啊。”
陈霄默不作声,从脑脊液来看,脑炎的几率已经非常非常低了。他见祁镜没有立刻发表看法,就先开口问道:“你们用了什么药?”
“先上的阿昔洛韦。”
“颈强有没有好转?头疼和视物模糊呢?”
“颈强依然三指,头疼有些加重了,视物模糊倒是好了些。”
祁镜在旁听着,觉得这病例越听越离奇。脑炎的症状,脑脊液却是一切正常。用上诊断性治疗后,病人来时的三个症状竟然朝着三个不同的方向发展。
一个颈项强直维持原样,一个头疼加重了,一个视物模糊却好转了。
有意思。
“只能麻烦陈老师跑一趟把病人接回来了。”祁镜看向陈霄说道,“这病人绝不可能是sars,隔离区的,你们认为呢?”
“我们找了感染病例数最多的京城和羊城,比对了所有病例的症状特点,已经排除了sars的可能性。”
陈霄快速起身,带上了小文:“好吧,我去接,谁让我是首诊呢。”
没一会儿病人被送进了观察室,陈霄带着一大叠病历检查记录回到了诊疗室。
“对了,陈老师,病人血糖多少?”
祁镜忽然想到了一种可能性,开口问道。
陈霄屁股还没靠上椅子,问题就传进了耳朵里,总觉得自己这个高年资住院做的非常憋屈。
在张杰义面前,实力是碾压的,可地位不够,忍忍也就算了。到了祁镜面前,地位有了,毕竟医院还是讲阶级制度的,但实力又压不住了。
本来消化科医生对肺部和脑部的感染就不是太在行,他又是个搞胃镜的,这方面更显得生疏。
现在他在急诊室里两头不靠,成了背锅和询问病史的小医生。很多事情看似他在做主,可背后都是祁镜的身影。
算了,不懂就得认栽,不懂就得学啊。
陈霄飞快地翻阅着混乱的检查报告单:“有糖尿病,来之前吃过东西,入院时是12.8,还好。”
祁镜总算捕捉到了里面的一条蛛丝马迹。
脑脊液里的葡萄糖含量一般是血糖的1/2-2/3左右,现在这个指标2.3,看上去和正常人没区别,但在这个病人身上却是低了。
原来爱吃甜食,祁镜马上在脑海里找到了几种爱吃软绵绵甜食的家伙。
“还是把抗病毒药撤了吧,改上氟康唑。”
祁镜接着又说了自己的诊断思路,陈霄实在搞不清几个脑膜炎造成的检查报告差异,见他如此肯定只能先按照这个方案来办。脑脊液培养需要很多时间,反正都是诊断性治疗,如果情况有变再改也不迟。