第二百三十四章 征服陈萱(1 / 2)
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是的,施远腾知道,只要他拿出听诊器,小孩肯定会哭。现在这种趁着小孩大笑,呼吸力度加大,施远腾也能听到比较清晰的呼吸音。
听了一会,施远腾又将小孩放在床上躺着,他则弯下腰,继续与小孩说着话,做着各种表情。与此同时,施远腾的手轻柔地做着脑膜刺激征的检查。当做到克氏征时,小孩终于因为疼痛而哭了起来,小孩的母亲赶紧向前哄着小孩。施远腾则在这个过程中,得到了他想得到的东西。
儿科的难,在于小孩不能清晰准确地表达他的不适,甚至根本不能说话。所以,古代称儿科为“哑巴”科。正因为如此,儿科疾病的诊断和治疗都比成人要难很多,这是施远腾想办医院,但一直不敢下决心的原因。没有专业的儿科医生坐镇,儿科无法开张。
大家回到课室,开始进行讨论。按照以往的惯例,儿科的医生们首先发言,说出自己对这个小孩的诊断和治疗意见。
从顾盼到主管的高级医生,他们目前将焦点集中在病毒脑的诊断上,唯一让他们感到为难的,是脑脊液的检查结果是明显不支持病毒脑的诊断的。
陈萱选择了沉默,她确实拿不准这个病人的诊断,既然请来了施远腾,她干脆不发表意见。
看见陈萱不吭声,作为老朋友,施远腾当然知道她的用意。
“我来说说我的看法。陈主任是我的朋友,更是我的老师,如果我有说得不对的地方,请陈主任、吴主任和各位批评指正。”虽然吴歌被撤掉副主任,但施远腾还是故意在各种场合称她为主任。
“这个施主任,如此的智慧,如此的胸怀,如此的自信,跟着他做事,肯定没错。”听罢施远腾的开场白,吴歌不由佩服不已。
“刚才各位医生都说了自己的看法,很多我都表示认同。多余的话我不说了,就说说我的看法吧。”
“这个患儿患病时间虽然有一个多月,但给我的感觉,他的精神状况还是挺好的。对外界的感知和反应能力都很敏捷,这对我们诊断提供了一个很重要的参考。”
“首先,这个小孩以发热起病,他发热非常有规律,是典型的午后潮热,而且体温都不是很高。”
“第二,小孩患病后,先后用过各种抗生素,而且用的头孢类的级别还挺高的,但没有一点效果。可能是小孩感染的细菌对头孢不敏感,也可能他的感染本身就是一种特异性的细菌感染,才会对头孢类抗生素不敏感。”
“第三,在体格检查方面,各位的经验比我丰富,我只能靠我的一些笨办法来检查。我刚才贴着小孩的胸壁,听了他的呼吸音,感觉是没有问题的。我又检查了小孩的脑膜刺激征,我认为,他的脑膜刺激征是阳性的。因为我做克氏征检查的时候,他的痛苦表情和他的大声哭叫,都说明了这个问题。”