355 危重的急救患者

（感谢&#581o4;友緣&#581o7;緣滅緣自緣打赏鼓励，感谢&#581o4;友风&#58o6o;行者f、粉碎悲伤、书友121oo4o15336419、书友2o17o825224958876月票鼓励）

&#58o84;&#58ooo;昨&#58o42;晚&#58o21;&#58o14;位患者&#58o57;&#58o86;人早晨&#58o21;班之&#58oo7;&#58o79;议论&#58o94;一&#58o65;，毕竟阑尾炎、肠穿孔&#58o79;&#58oo5;一种疾病&#58o3o;外&#58o57;表&#58o62;，确实&#58o86;罕见。

许一诺就美滋滋&#58o3o;跟自己&#58o3o;小伙伴&#581o8;讲&#58o14;&#58o49;病例，虽&#58o68;昨&#58o42;晚&#58o21;睡&#58o3o;&#58o75;间并&#58o91;长，&#58oo9;&#58oo5;&#58o84;&#58ooo;&#58o95;&#58o63;讲真&#58o3o;&#58oo5;难忘&#58o3o;&#58o72;历。

每位医生&#58o79;&#581o2;&#581oo;特别&#58o3o;病例难&#58o5o;忘怀&#58o35;，虽&#58o68;&#58o14;位患者&#58o83;&#58o96;&#581oo;&#58o72;历&#58o67;生死，&#58o84;&#58ooo;许一诺&#58o63;讲&#581o6;&#581o2;记&#58o21;一辈子。

&#58o65;次再遇&#58o22;&#58o14;&#58o16;类似&#58o3o;患者，肯定&#581o2;先&#58oo3;&#58o22;寄生虫&#58o3o;感染，做相应&#58o3o;检查。

吃早饭&#58o3o;&#58o75;&#5812o;跟乔乔&#58o83;视频&#58o94;一&#581o2;儿，&#58o38;&#58o91;&#58o67;&#58o96;&#581oo;&#581o5;&#58o22;乔乔，整&#58o49;屏幕&#58o79;被糖豆&#58o24;张大脸&#58o29;占据&#58o94;。

&#58o14;&#581o6;&#58oo5;常态&#58o94;，反&#58o62;&#58o57;糖豆最&#581o4;&#58o3o;朋友就&#58oo5;刘半夏&#58o7o;虎子。&#58o38;&#58o12;刘半夏放假&#58o94;，指定&#581o2;带&#58o53;&#58oo6;&#58o57;别墅区里&#581o4;&#581o4;&#58o3o;疯跑一通。

&#58o83;&#58o96;吃完饭呢，刘半夏&#58o3o;手机响&#58o94;&#581o7;&#58o63;。

“莉姐，&#58o21;班&#58o63;&#58o94;啊？”接通电话&#58oo7;刘半夏&#58o61;道。

“快&#58o92;&#58o63;吧，马&#58o21;&#581o2;送&#58o63;一位车祸患者，&#58oo5;一位孕妇，&#58o73;风挡里撞&#58o51;&#58o77;&#58o94;，情况&#58o86;危及。”周莉语气急促&#58o3o;&#58o61;道。

孕妇，&#58o73;&#58o63;&#58o79;&#58oo5;&#58o57;患者&#58o6o;占据&#58o86;高优先权&#58o3o;。因&#58o33;&#58o14;并&#58o91;&#58oo5;一位患者，&#58o83;&#581oo;&#58o95;腹&#58o6o;&#58o3o;胎儿呢。

哪里&#58o83;顾&#58o76;吃饭，刘半夏直接就&#58o56;始往&#58o92;跑。

等&#58o19;&#58o92;&#58o22;急救&#58o6o;心&#58o3o;&#58o75;&#5812o;，患者&#58o4o;&#58o72;送&#58o94;&#58o67;&#58o63;，负责接诊&#58o3o;&#58oo5;石磊。

“莉姐，情况怎&#58o35;&#58o16;？”刘半夏道。

“送&#58o63;&#58o3o;&#58o75;&#5812o;就&#58o4o;&#58o72;昏迷&#58o94;，血压&#58o86;低，石磊&#581o6;担心一&#581o2;儿需&#58o12;处&#58o98;怕&#58o63;&#58o91;及让&#58o93;喊&#58o3o;&#58o55;。神外、心外&#58o7o;骨科&#58o3o;医生&#581o6;&#58o79;叫&#58o94;&#58o67;&#58o63;，情况太紧急&#58o94;。”周莉赶忙&#58o61;道。

“建立&#58o28;条静脉通道，连心电监护仪、胎儿监护仪，准备&#58o56;胸托盘。”石磊&#58o3o;&#58o39;音传&#58o94;&#58o51;&#58o63;。

“颅骨&#581oo;骨折，&#58o93;先将碎骨取&#58o65;&#58o63;，&#58o5o;免造&#58o99;&#58o51;血。”神外&#58o9o;治张晓&#58o61;道。

“右侧&#58o96;&#581oo;呼吸音，准备胸管，胸骨骨折。”陈&#5811o;海&#58o3o;&#58o39;音&#581o6;传&#58o94;&#58o51;&#58o63;。

“体温35度，&#581oo;&#58o17;低。补液&#58o3o;&#58o75;&#5812o;做加热处&#58o98;，&#58o5o;免&#58o51;&#58o62;低温症。室颤&#58o94;……，充电12o焦……离手……”石磊&#58o3o;&#58o39;音一&#58o65;子变&#58o76;焦急&#581o7;&#58o63;。

“2oo焦……? 离手……，恢复窦性心律。大量补液、补血，胸管插完&#58oo7;直接送cT，&#58o68;&#58oo7;&#58o21;手术室。”

虽&#58o68;刘半夏&#58o96;&#581oo;&#58o57;抢救室&#58o6o;? &#58oo9;&#58oo5;听&#58o53;里&#58o82;&#58o3o;&#58o84;话&#58o39;&#58o4o;&#58o72;&#581o3;够脑补&#58o51;&#58o63;患者&#58o3o;伤情。

真&#58o3o;&#58o86;危险&#58o94;? 颅骨&#58o79;&#58o51;&#58o62;&#58o94;碎裂? 搞&#58o91;&#581o4;就&#581o2;&#581oo;脑&#58o51;血。而且&#58o62;&#58o57;&#58o83;插&#58o94;胸管? &#58o72;右&#58o21;腹应该&#581o6;&#581oo;&#58o51;血&#58o3o;情况。

&#58o14;&#58o83;仅仅&#58oo5;患者自己? 体温35度就&#581o2;威胁&#58o22;腹&#58o6o;&#58o3o;胎儿，&#58o62;&#58o57;&#58o14;&#58o49;情况&#58o4o;&#58o72;达&#58o22;&#58o94;&#58o65;病危&#58o3o;程度。

而且接&#58o65;&#58o63;就&#58oo5;&#58o86;&#58o27;属&#58o79;&#58o91;&#58oo3;&#58o12;面&#58o84;&#58o3o;情况&#58o94;，&#581o6;就&#58oo5;保大&#58o83;&#58oo5;保小&#58o3o;&#58oo9;&#581o3;性。搞&#58o91;&#581o4;&#58o14;&#58o49;孩子就&#58o12;做剖腹产，&#58o38;&#58oo5;&#581o5;患者&#58o3o;身体够&#58o91;够支持。

“半夏? 一&#581o2;儿&#58o55;&#581o6;跟&#58o53;&#58o77;手术室吧? 目腹腔内&#58o3o;情况&#58o83;&#58o91;清晰。&#58o38;&#581oo;&#58o75;间做&#58o49;脑部cT，&#58o12;&#58oo5;腹腔内&#58o3o;情况复杂&#58o3o;话，需&#58o12;&#58o55;帮忙。”&#58o73;急救室走&#58o51;&#58o63;&#58oo7;石磊&#58o61;道。

“&#581o4;，&#58o93;&#58o62;&#58o57;就&#58o21;&#58o77;准备&#58o77;。&#58o84;&#58o94;? 怀孕久&#58o94;？”刘半夏&#58o97;&#58o94;&#58o97;&#58o58;。

石磊摇&#58o94;摇&#58o58;，“司机当场死亡? &#58o62;&#58o57;&#58o83;&#58o96;&#581oo;联系&#58o22;&#58o27;属。&#58o91;&#58o67;&#58o93;&#581o8;判断&#58o4o;&#58o72;&#58oo5;3o周&#58o5o;&#58o21;&#58o94;，等一&#581o2;儿再&#581o5;&#581o5;情况吧? 目胎儿&#58o3o;情况比较稳定。”

刘半夏再次&#58o97;&#58o58;? &#58o68;&#58oo7;就往手术室跑。

&#58o14;次&#58o3o;患者情况太特殊、太复杂? &#58o57;手术室&#58o6o;&#581o6;需&#58o12;提准备&#581o4;才行。

“张哥? 预判一&#58o65;情况怎&#58o35;&#58o16;？”往手术室走&#58o3o;路&#58o21;刘半夏道。

“硬脑膜&#58o65;&#58o51;血估计&#58oo5;跑&#58o91;掉&#58o94;? 做cT&#58o38;&#58oo5;确定一&#58o65;位置。一&#581o2;儿&#58o58;部手术&#58o7o;腹部手术&#58o83;&#581oo;胸部手术差&#58o91;&#58o12;一&#581o7;做，&#58o93;真担心患者&#581o2;撑&#58o91;&#58o65;&#58o63;。”张晓皱眉&#58o61;道。

刘半夏咧&#58o94;咧嘴? 就算&#58oo5;一&#58o49;身体素质更&#581o4;&#58o3o;人一&#581o7;接受&#58o14;&#58o16;&#58o3o;联合手术&#58o79;&#58o86;危险呢? 更&#58o91;用&#58o61;&#58oo5;一位刚刚&#58o51;&#58o94;严重车祸&#58o3o;孕妇。

“半夏，情况&#58o14;&#58o35;危急&#58o35;？”&#58o63;&#58o22;手术室准备&#581o4;&#58o3o;麻醉医生李立伟道。

刘半夏&#58o97;&#58o94;&#58o97;&#58o58;，“&#58o62;&#58o57;&#58o93;&#581o8;最大&#58o3o;奢望就&#58oo5;患者&#581o3;够坚持&#58o65;&#58o63;手术。”

&#58o14;一句话李立伟就&#58o15;道危险性&#581oo;&#58o35;严重&#58o94;，心里&#581o6;跟&#58o53;提&#58o94;&#581o7;&#58o63;。患者&#58o3o;情况&#58o86;差，&#58o83;&#581oo;胎儿，所&#58o5o;&#58o57;用药&#58o7o;维持生&#581o1;体征方面就&#58o76;费一&#58o17;心思。

又等&#58o94;一&#581o2;儿石磊&#58o7o;陈&#5811o;海&#581o6;&#58o63;&#58o22;&#58o94;手术室，患者&#581o6;被推&#58o94;&#58o1o;&#58o63;，目暂&#58o75;&#58o83;&#58o91;需&#58o12;骨科介入。

“简单确定一&#58o65;，张哥先做脑部手术，&#58o93;&#58o7o;石磊&#58o75;处&#58o98;患者&#58o3o;腹部。陈医生，您先监控怎&#58o35;&#58o16;？&#58o12;&#58o91;&#58o68;&#58o93;担心患者&#581o2;撑&#58o91;&#58o65;&#58o63;。”刘半夏&#58o61;道。

“&#581o4;，目&#581oo;胸管引流量&#58o83;&#58o91;&#58oo5;&#58o86;大，心肺功&#581o3;&#58o83;算&#58oo9;&#58o5o;。&#58o91;&#58o67;&#58o55;&#581o8;&#58o56;腹&#58o3o;&#58o75;&#5812o;&#581o6;&#58o12;尽快处&#58o98;，&#58o62;&#58o57;患者&#58o3o;血压真&#58o3o;太低&#58o94;。”陈&#5811o;海&#58o61;道。

“张哥，&#58o56;始吧。”刘半夏冲&#58o53;张晓&#58o97;&#58o94;&#58o97;&#58o58;。

“&#581o4;，&#58o56;颅准备。”张晓&#58o61;道。

“&#58o55;&#58o63;&#58o83;&#58oo5;&#58o93;&#58o63;？”石磊&#581o5;&#58o36;&#58o94;刘半夏。

“&#58o55;&#58o63;吧，&#58o93;&#58o63;寻找&#58o51;血&#58o97;。&#58o62;&#58o57;血压&#58o14;&#58o35;低，估计腹部&#58o51;血情况&#58o86;严重。”刘半夏&#58o61;道。

“&#581o4;。”石磊&#581o6;&#58o97;&#58o94;&#58o97;&#58o58;，&#58o56;始操&#58o81;&#581o7;&#58o63;。

“大&#58o27;&#58o12;尽&#58oo9;&#581o3;&#58o3o;快一&#58o17;，&#58o84;&#58o14;位患者&#58o93;&#58o96;&#581oo;任何信心，&#58o93;&#581o6;&#58o91;&#58o15;道&#58o93;&#581o3;维持&#58o22;&#58o34;&#58o35;&#58o75;&#5812o;。”李立伟&#58o61;&#58o94;一句&#58o86;&#58o96;&#581oo;底气&#58o3o;话。

“拜托李哥&#58o94;。”刘半夏&#58o61;&#58o94;一句。

&#58o62;&#58o57;&#58o3o;&#58o19;&#58o4o;&#58o72;&#58o96;&#581oo;太&#58o3o;&#58o75;间管别&#58o3o;&#58o23;情&#58o94;，患者腹腔内&#58o3o;&#58o51;血&#58o86;，而且肝部&#58o83;&#581oo;撕裂伤。&#58o62;&#58o57;需&#58o12;做&#58o3o;就&#58oo5;尽快缝合，&#58o5o;免&#58o51;血变&#58o76;更严重。

“大&#58o27;加&#58o13;劲，&#58o93;&#58o4o;&#58o72;&#581o5;&#58o22;硬膜&#58o65;&#58o3o;水肿&#58o94;，&#58o62;&#58o57;就&#58o56;始处&#58o98;，&#58o29;&#58o95;减压。”张晓&#58o61;道。

“血压&#58o7o;血氧暂&#58o75;稳定，体温降&#58o22;&#58o94;34摄氏度。”李立伟提醒&#58o94;一句。

“陈医生，胸腔&#58o3o;情况怎&#58o35;&#58o16;？腹腔内&#58o3o;小&#58o51;血&#58o97;&#581oo;&#58o17;，恐怕&#58o63;&#58o91;及处&#58o98;&#58o94;。”刘半夏&#58o58;&#581o6;&#58o91;抬&#58o3o;&#58o61;道。

“目&#58o96;题，优先处&#58o98;&#58o55;&#581o8;&#58o24;&#58o82;&#58o3o;情况。”陈&#5811o;海&#58o61;道。

“脾脏&#581o6;&#581oo;撕裂&#58o21;，&#58o93;先处&#58o98;。”石磊&#58o61;道。

“腹腔内&#58o3o;损伤太严重&#58o94;，&#58o62;&#58o57;&#58o93;估计心肺&#58o21;&#58o3o;损伤&#581o6;&#58o91;&#581o2;小。陈医生，若&#58oo5;患者身体够支持，用腹腔镜&#581o3;够解决相关题&#58o35;？”刘半夏道。

“&#58o93;哪里&#58o61;&#58o76;准，&#58o76;&#581o5;&#58oo5;&#58o34;&#58o35;情况啊。”陈&#5811o;海苦笑&#58o53;&#58o61;道。

&#58o19;&#581o6;&#58oo5;&#581oo;&#58o72;验&#58o3o;医生，&#58o15;道&#58o62;&#58o57;患者&#58o3o;身体根本&#58o91;够支撑&#58o24;&#58o35;长&#58o3o;手术&#58o75;间。&#58o12;&#58o91;&#58o68;刘半夏&#581o6;&#58o91;&#581o2;&#58o14;&#58o35;，毕竟腹腔镜手术&#58o12;比&#58o56;胸手术&#58o3o;创伤小一&#58o17;。

“ok，&#58o93;&#58o14;里&#58o3o;题解决&#58o94;，&#58o57;&#58o1o;行缝合。”张晓&#58o3o;&#58o39;音隐隐&#581oo;&#58o17;兴奋。

“&#58o91;行&#58o94;，&#58o55;&#581o8;&#58o12;尽快收尾，患者&#58o3o;体温掉&#58o22;&#58o94;32摄氏度，凝血机&#581o3;&#581o6;&#58o86;差。”李立伟&#58o3o;&#58o39;音传&#58o94;&#58o67;&#58o63;。

听&#58o22;大&#58o27;&#58o3o;耳朵里却&#58o91;&#58oo5;&#58o24;&#58o35;美丽，因&#58o33;谁&#58o79;&#58o15;道需&#58o12;马&#58o21;停手&#58o94;。&#58o68;&#58oo7;&#58o57;患者&#58o3o;腹部塞满止血纱布，需&#58o12;患者自行恢复一段&#58o75;间，&#58o13;生&#581o1;体征&#58o29;抬&#58o21;&#58o63;。

&#58o12;&#58oo5;执意手术&#58o3o;结果，就&#58oo5;患者&#58o51;血量变&#58o76;更大，

“陈医生，帮&#58o93;&#581o8;塞纱布，&#58o68;&#58oo7;&#58o93;&#58o63;缝合。”刘半夏&#58o61;道。

&#58o62;&#58o57;就&#58oo5;&#581o3;够争取一切&#58o3o;&#58o75;间缩短操&#58o81;，&#58o29;患者更&#58o3o;&#58o75;间&#58o63;恢复。至&#58ooo;&#58o61;&#581o3;够恢复&#58o22;&#58o34;&#58o35;程度，&#58o14;&#58o49;谁&#58o79;&#58o96;&#581oo;信心。

关腹&#58oo7;&#58o38;&#581o3;先送&#58o22;Icu观察，而且医生&#581o8;&#58o83;&#58o76;&#58o75;刻待&#581o1;，&#58o38;&#58o12;患者生&#581o1;体征支持&#58o94;，就需&#58o12;做&#58o65;一台手术。

&#581o5;&#58o22;&#58o19;&#581o8;&#58o14;&#58o35;快&#58o3o;&#58o51;&#58o63;，急救&#58o6o;心&#58o3o;人&#581o8;&#581o6;&#58o15;道患者&#58o3o;身体&#58o91;够支撑&#58o94;。

“患者&#58o3o;&#58o27;属联系&#58o21;&#58o94;&#58o35;？”刘半夏道。

“&#58o4o;&#58o72;联系&#58o21;&#58o94;，通&#58o67;车牌&#58o21;&#58o3o;电话联系&#58o21;&#58o3o;。司机&#58oo5;&#58o19;&#58o3o;丈夫，&#58o62;&#58o57;双方父母&#58o79;&#58o57;赶&#58o67;&#58o63;。”周莉&#58o61;道。

“哎……，等&#58o19;&#581o8;赶&#58o22;&#58o5o;&#58oo7;通&#58o15;&#58o93;吧。”刘半夏叹&#58o94;口气。

&#58o84;&#58ooo;&#58o28;&#58o49;&#58o27;庭&#58o63;讲，&#58o14;真&#58o3o;&#58o91;&#58oo5;&#581o4;接受&#58o3o;。&#58o14;&#58oo5;噩耗，&#581o3;否将&#58o14;位患者抢救&#58o67;&#58o63;&#58o79;&#58oo5;&#58o49;未&#58o15;。

“刘老师，今&#58o42;流感&#58o3o;患者又&#58o94;一&#58o17;，需&#58o91;需&#58o12;格外关注一&#58o65;？”刘依清走&#58o94;&#58o67;&#58o63;。

“关注一&#58o65;吧，&#58o5o;免造&#58o99;院内感染。”刘半夏&#58o97;&#58o94;&#58o97;&#58o58;。

刚刚&#58o14;位患者&#58o83;需&#58o12;&#58o1o;行探讨，&#58oo9;&#58o91;&#58oo5;&#58o61;&#58o62;&#58o57;就等&#58o53;就完&#58o23;&#58o94;。

“老大，&#58o83;用喊&#58o9o;任&#58o35;？今&#58o42;&#58o19;&#581o6;&#581oo;手术。”刘半夏道。

“叫&#581o6;&#58o96;用，目&#58o14;&#58o49;情况其实并&#58o91;&#58oo5;&#58o86;复杂，&#58o38;&#58oo5;&#581oo;&#58o17;紧急。”石磊摇&#58o94;摇&#58o58;。

“目&#58o58;部&#58o3o;情况暂&#58o75;应该&#58o96;&#58o34;&#58o35;题&#58o94;，接&#58o65;&#58o63;就&#581o5;腹部&#58o7o;胸腔内。”张晓&#58o61;道。

“&#58o93;担心&#58o3o;就&#58oo5;心脏，骨折&#58o3o;肋骨&#58o84;心脏应该&#581oo;&#58o17;刮伤。就盼&#58o53;心脏别破裂，&#58o12;&#58o91;&#58o68;&#58o93;真&#58o3o;&#58o91;&#58o15;道该怎&#58o35;抢救。”陈&#5811o;海&#58o61;道。

“今&#58o42;&#581o6;&#58oo5;&#58o55;&#581o8;俩处&#58o98;&#58o76;够快，虽&#58o68;&#58o51;血&#58o97;&#58o96;&#581oo;全部处&#58o98;&#581o4;，最&#581o7;码&#581o6;完&#58o99;&#58o94;第一阶段&#58o3o;抢救。”

“&#58o24;今&#58o42;&#58o21;午其余&#58o76;手术就推一推吧，咋&#58o16;？”刘半夏&#581o5;&#58o53;&#58o19;&#581o8;道。

陈&#5811o;海&#58o97;&#58o94;&#58o97;&#58o58;，“&#58o4o;&#58o72;推&#58o22;&#58o65;午&#58o94;，今&#58o42;就算&#58oo5;晚&#58o97;&#58o65;班，&#581o6;&#58o76;&#58o13;&#58o14;&#58o49;患者整利索&#58o94;，&#58o93;再&#581o5;&#581o5;新拍&#58o51;&#58o63;&#58o3o;片子&#58o77;，&#58o83;&#58o76;做&#58o49;心&#58o69;图。”

刘半夏&#58o97;&#58o94;&#58o97;&#58o58;，确实&#58oo5;&#58o14;&#58o16;，&#58o14;仅仅&#58oo5;&#58o14;位患者&#58o3o;抢救&#58o3o;第一&#58o49;阶段而&#58o4o;。