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  听&#58oo8;石磊召唤，许辉&#581o4;跟&#58oo5;一溜烟往Icu跑。&#58o59;&#58o44;&#58o69;等&#58oo5;坐电梯，而&#58o47;跑楼梯。  “&#58o13;&#58o5o;患者颅内压又高许&#58o48;，&#58o44;法等更久，&#58o18;刚刚让人抽血。&#58o28;就算&#58o47;目测话，患者应该&#581oo;&#581o9;&#58o46;生贫血。”守&#58o5o;Icu张晓&#58o65;道。  “体温&#58o53;肾功呢？”刘半夏&#58o38;道。  “体温&#58o44;&#58o69;降&#5812o;&#58o9o;，&#58o28;&#581o4;&#58o44;&#58o69;升高太&#58o48;，比&#5812o;手术台&#58o51;&#58o12;高o.5摄氏度。尿检应该&#58o17;&#58o44;&#58o69;查。”张晓&#58o65;道。  “再做一&#58o36;加急尿检，血检&#58o37;&#581o4;重&#58o74;关注一&#5812o;肾功。”刘半夏&#58o65;道。  “&#58o13;&#58o5o;&#58o18;怀疑患者目&#58o7o;状况&#58o47;TTp，如果够确诊话，&#58o18;&#58o11;&#58o19;:行血浆置换，等血小板升&#58o63;&#58o9o;就&#58o19;做减压手术。”  “TTp？&#58o4o;吧？&#58o72;真&#58o47;&#58o39;&#58o35;&#58o18;&#58o19;&#58o47;差&#58o74;害死患者。”张晓&#58o69;&#58o57;吃惊&#58o65;道。  “&#58o13;&#58o5o;&#58o47;讨论&#58o39;&#58o36;&#58o51;&#58o12;，&#58o17;&#58o47;先检查吧。如果五联症&#581o8;&#58o63;四&#58o36;，应该&#581o4;差&#58o48;，咱&#58o11;就&#581o1;赶紧:行救治。”刘半夏&#58o65;道。  张晓&#58o74;&#58o74;&#58o55;，直接跟Icu沟通&#58o49;&#58o9o;。  &#58o13;&#58o5o;&#58o19;&#58o47;真敢耽搁，因&#58o68;TTp&#581o4;就&#58o47;血栓性血小板减少性紫癜，病程非常短，死亡率非常高。  &#58o39;&#58o59;&#58o47;&#58o92;&#58o92;手术&#58o38;题，而&#58o47;够直接威胁&#58oo8;患者生&#58o77;症状。详细检查手段&#58o66;繁琐，&#58o23;&#58o47;&#58o5o;临床&#58o63;&#58o9o;讲基本&#58o63;&#58o4o;用“五联症”&#58o9o;判断。  血小板减少、体温升高、贫血、急性肾功全、神&#581o9;系统症状，&#58o39;就&#58o47;TTp“五联症”。  目&#58o7o;患者&#58o5o;昏迷状态，所&#58o37;枢神&#581o9;&#58oo6;检测，&#58o19;&#58o47;其余方面&#58o17;&#58o47;&#58o66;轻松就够拿&#58oo8;结果。&#58o13;&#58o5o;所差&#581o4;就&#58o47;贫血&#58o53;急性肾衰竭而&#581oo;，&#58o54;&#58o84;&#58o19;让实验室做专项分析。  四&#58o36;人就守&#58oo5;化验结果，让实验室&#58o39;&#58o32;&#58o59;变&#581o1;&#58o66;紧张。  “确实&#58o69;肾衰表&#58o13;，&#58o19;吧？”结果&#58o97;&#58o9o;&#58o84;，负责检测医生&#58o59;兴奋喊一&#58o41;。  叮！诊断任务完&#58o96;  获&#581o1;&#581o9;验值3oo&#58o74;，诊断&#58o82;技熟练度2oo&#58o74;，荣耀值5&#58o74;  “妥，谢谢啊。”  刘半夏&#58o65;一句，&#58o54;&#58o84;四&#58o36;人扭&#58o55;就跑，连化验单&#58o59;忘拿。  针&#581o8;TTp救治就非常简单，&#58o86;就&#58o47;用血浆置换。  方法&#58o47;将患者全血引&#58o97;体外，分离&#58o96;血浆&#58o53;细胞&#58o96;分，&#58o54;&#58o84;将患者血浆舍弃，用等速度将新鲜血浆、白蛋白溶液等血浆代替品代替分离&#58o97;血浆，&#58oo9;输&#58oo8;患者体内。  &#58o39;&#58o35;方法目&#58o7o;&#58o66;常用，&#581oo;&#581o9;&#58o47;一种&#58o66;&#58o96;熟体外循环血液净化疗法。  虽&#58o54;&#58o65;&#581o4;&#58o47;需&#58o72;&#58o51;间，&#58o23;&#58o47;&#581o8;&#58o89;目&#58o7o;患者&#58o9o;讲，即便&#58o47;升高颅压&#58o59;&#581o1;排&#58o5o;&#58o84;&#58o32;。TTp症状，才&#58o47;目&#58o7o;最紧急。  “刘总啊，&#58o22;&#58o47;咋&#58o85;&#58oo8;呢？”许辉&#58oo6;奇&#58o38;道。  “半蒙半判断吧? 毕竟TTp&#58o53;dIc&#58o5o;临床&#58o63;&#58o66;&#58o48;&#58o51;&#58o12;&#58o59;容易混淆。”刘半夏笑&#58oo5;&#58o65;道。  “&#58o22;&#58o11;&#58o5o;一&#581o6;始&#58o51;&#58o12;肯定&#581o4;&#58o85;&#58o28;&#58o47;&#58o47;弥漫性血管内凝血，&#58o54;&#58o84;觉&#581o1;&#58o69;&#58o57;症状符，&#581o4;&#58o64;继续&#58o3o;患者挂血浆、挂血小板。”  “&#58o18;就觉&#581o1;&#58o39;&#58o31;&#58o36;病既&#58o54;&#58o39;&#58oo2;容易混淆，&#58o86;&#58oo2;反&#58o28;&#58o9o;&#58o85;话? 排除&#58o86;&#58o36;? &#58o4o;&#58o47;就&#58o47;另一&#58o36;呢？”  “其实最关键&#58o17;&#58o47;&#58o39;&#58o57;血小板? &#58o18;&#58o11;&#58o5o;一&#581o6;始&#58o51;&#58o12;&#58o64;&#58o47;考虑&#58oo8;减少原因&#58o47;患者某种病症让血小板生&#58o96;减少。&#58o23;&#58o47;减少方法&#581o4;&#58o19;&#58o47;被摧毁啊? &#58o18;就&#58o85;&#58oo8;&#58o39;&#58o36;。”  石磊&#58o56;人互视一&#58o25;? 露&#58o97;苦笑。  &#58o39;&#58o36;&#58o93;情如果&#58o43;结果&#58o9o;往&#58o7o;推话，一切&#58o59;&#58o47;&#58o86;&#58oo2;简单。&#58o19;&#58o47;&#58o66;&#58o48;&#58o51;&#58o12;诊断病情就跟变魔术一&#58o35;，哪怕&#58o64;&#58o47;隔&#58oo5;一张纸，&#58o22;&#581o4;&#5811o;&#58oo8;详细情况&#58o47;啥。  &#58o56;&#58o36;人&#58o5o;一&#58o49;讨论&#58o86;&#58oo2;久? &#581o4;&#58o44;&#58o69;刘半夏&#58oo9;办公室自己琢磨效果&#58oo6;。  最&#58o68;关键一&#58o36;&#58o38;题&#58o47;啥呢？刘半夏&#58o47;石磊带&#58o97;&#58o9o;? 目&#58o7o;&#581o4;仅仅&#58o47;刚刚结束规培久住院医。&#58o99;&#58o11;&#58o56;&#58o36;&#58o59;&#58o47;各&#58o36;科室佼佼者，&#58o47;高资&#58o75;治。  “&#58o39;&#58o32;&#58o44;&#58o18;啥&#58o93;吧？&#58oo9;&#58o55;等患者血小板升&#58o63;&#58o9o;，&#58o22;&#58o11;就安排手术吧。&#58o18;先&#58oo9;楼&#5812o;&#58o61;，今&#58o87;&#581o4;&#58o69;&#58o57;忙。”&#58o65;完之&#58o84;刘半夏溜溜达达就走&#581o6;。  “石磊啊? &#58o22;跟刘总相处&#58o51;间最长，&#58o22;&#58o69;啥&#58o85;&#58o65;？”许辉笑&#58oo5;&#58o38;道。  石磊苦笑&#58oo5;摇摇&#58o55;? “&#58o44;啥&#58o85;&#58o65;，&#58o18;&#58o59;&#58o83;道该&#58o65;啥&#58oo6;。&#58o22;&#58o44;啥&#58o85;&#58o65;？&#58o22;&#58o47;内科医生啊。”  许辉翻&#58o36;白&#58o25;? “咱&#58o11;&#58o39;&#58o57;&#58o7o;浪啊? &#581oo;&#581o9;被&#58o84;浪&#58o3o;拍&#581o1;死死? 翻身喽。”  “哈哈? 跟&#58o18;&#58o44;关系? &#58o18;就&#58o47;神外医生而&#581oo;。”张晓笑眯眯&#58o65;道。  “&#58o69;啥&#58oo6;高兴？&#58o39;&#58o36;货指定啥&#58o51;&#58o12;就&#58o19;&#58o61;抢&#58o22;活干。”许辉&#58o65;道。  “&#58o5o;原先急诊科&#58o99;就干&#58o28;心外活，&#58o13;&#58o5o;&#58o5o;急救&#58o37;心更&#58o47;将&#58o66;&#58o48;骨科活&#58o3o;包。&#58o22;就够确定&#58o99;哪&#58o87;&#58o4o;&#58o9o;&#58o36;急救&#581o6;颅？”  张晓&#581o4;变&#581o1;&#58o66;愁? &#58o39;&#58o36;&#58o93;情&#58o17;真&#58o65;准。  考量神外医生一&#58o36;最基本&#58o72;素? 就&#58o47;手&#58o72;够稳、够快。&#58o5o;&#58o39;一&#58o74;&#58o63;，刘半夏&#58o47;完全合格，甚至&#58o89;比&#58o99;&#58o17;&#58o72;强。  真&#58o65;&#58oo6;&#58o91;&#58oo2;&#58o51;&#58o12;刘半夏就&#58o4o;&#58o3o;&#58o22;&#58o9o;&#58o63;一手，&#58o13;&#58o5o;&#58o99;连内科活&#58o59;干&#581o1;&#58o39;&#58oo2;溜，普外&#58o53;骨科活&#581o4;非常棒，&#58o17;&#58o69;啥&#58o99;干？  “哎呀，&#58o18;&#58o85;&#58o49;&#58o9o;。”张晓冷丁&#58o9o;一句。  “&#58o22;&#58o11;&#58o17;记&#581o1;？&#58o69;一位患者:行性麻痹，&#58o84;&#58o9o;&#58o17;&#58o47;肖&#58o75;任亲自&#58o75;刀，打&#581o6;脊髓找&#58oo8;血肿？”  石磊&#58o74;&#58o74;&#58o55;，“怎&#58o11;记&#581o1;，就&#58o47;&#58o39;小子&#58o83;道深浅乱&#58o65;话&#58o9o;&#58oo5;。当&#58o51;&#58o3o;周&#58o75;任&#58o59;吓一跳，觉&#581o1;&#58o39;小子胆子&#581oo;&#581o9;肥&#581o1;&#58o44;&#58o32;。”  “&#58o86;&#58o51;&#58o12;肖&#58o75;任&#58oo9;&#58oo8;办公室就&#58o65;&#58o28;，刘半夏其实应该&#58o9o;神外。&#58o99;观察&#581o1;非常仔细，&#58o5o;神外手术&#58o28;程&#58o37;&#58o4o;&#58o69;&#58o66;大帮助。”张晓苦笑&#58oo5;&#58o65;道。  “哎……，&#58o17;&#58o65;啥？”许辉&#58o66;&#58o47;无奈&#58o65;道。  “心外李副院长，普外周&#58o75;任、神外肖&#58o75;任，骨科徐&#58o75;任，&#58o39;&#58o59;&#58o47;咱&#58o11;院镇院之宝级人物啊。&#581o4;就&#58o47;周&#58o75;任抢先，真&#58o47;香饽饽啊。”  “关键&#58o47;&#58o99;&#58o17;&#58o66;轻啊，&#58o13;&#58o5o;&#58o18;&#58o47;真服。咱&#58o11;二院&#58o17;真&#58o4o;培养&#58o97;一位牛人&#58o9o;，就&#58o47;&#58o83;道&#58o99;自己界限究竟&#58o5o;哪里。”  “&#58o13;&#58o5o;&#581o4;就&#58o47;&#58o5o;执业范围&#58o63;&#58o69;限制，&#58o72;&#58o47;&#58o44;&#58o69;限制话，&#58o22;&#58o11;&#58o65;&#58o99;&#58o4o;&#58o4o;&#58o16;所&#58o69;科室&#58o59;&#58o3o;注册一遍？”  听&#58oo8;许辉话大&#58o15;伙&#58o59;乐&#58o49;&#58o9o;，&#58o28;笑容背&#58o84;&#581o4;&#58o47;&#58o69;&#58o57;羡慕。  人精力&#58o47;&#58o69;限，&#58o19;&#58o47;&#58o5o;刘半夏&#58o39;里呢？貌似&#58o39;&#58o36;限制就变&#581o1;&#58o69;&#58o57;弱。&#58o39;&#58o36;货&#58o5o;&#58o66;&#58o48;&#58o82;科方面展&#58o13;&#58o97;&#58o9o;&#58o87;赋&#58o59;&#58o66;强，真心比。  &#58oo9;&#58oo8;一楼刘半夏心情&#58o66;错，就算&#58o47;&#58o3o;&#581o9;验并&#58o48;，&#581o4;&#58o47;挽救一条生&#58o77;嘛。&#5811o;&#58o9o;&#58o5o;系统判定&#58o37;，&#58o17;&#58o47;&#58o66;&#58oo6;诊断，就&#58o47;&#5811o;&#58o69;&#58o48;细心。  伸&#58o36;大大懒腰，&#58o17;&#581o1;&#58o3o;六小&#58o64;制定培训计划。&#58o19;将&#58o99;&#58o11;一&#5812o;子&#58o59;&#58o3o;送&#58o28;&#58o61;，目&#58o7o;&#58o39;&#58o32;接诊量&#581o4;&#58o63;&#58o9o;，&#58o69;&#58o99;&#58o11;&#58o5o;大&#58o15;&#58o59;够轻松一&#58o57;。  而且&#58o5o;&#58o39;里&#581o4;够&#58o3o;&#58o99;&#58o11;更&#58o48;实操机&#58o4o;，&#58o44;法做&#58oo8;资源公平分配，&#58o13;&#58o5o;&#58o99;&#58o11;就&#58o47;接诊&#58o68;&#58o75;。谁接诊患者，谁就&#58o69;机&#58o4o;&#58o63;台参与手术。  而且&#58o99;&#58o17;&#581o1;尽&#58o19;挤&#58o97;&#58o51;间&#58o9o;，召集大&#58o15;一&#58o49;&#581o6;病例研讨&#58o4o;。  &#58o39;&#58o36;&#58o51;间&#581o4;&#58o47;&#58o86;&#58oo2;&#58oo6;凑嘛，并&#58o47;&#58o65;&#58o22;一&#58o41;令&#5812o;就够&#58o16;大&#58o15;&#58o59;凑&#58o28;&#58o9o;，&#58o17;&#581o1;留&#5812o;人&#58o9o;接诊。  针&#581o8;&#58o89;急救&#58o37;心&#58o9o;讲，目&#58o7o;就&#58o64;&#58o47;机&#58o92;性，&#58o44;法确定哪&#58o87;哪&#58o36;&#58o51;间段。&#58o64;&#58o47;赶&#58oo5;&#58o9o;，&#5811o;&#58o91;&#58oo2;&#58o51;&#58o12;患者少。  &#58o13;&#58o5o;&#58o99;&#58o48;少&#581o4;&#58o69;&#58o57;心累感觉，&#58o7o;&#58o99;&#58o43;&#58o9o;&#58o59;&#58o44;&#58o69;&#58o85;&#58o28;&#58o17;&#58o4o;&#58o69;机&#58o4o;操&#58o39;份儿心。&#58o13;&#58o5o;就&#58o96;，&#58o68;将&#58o9o;幸福，就&#581o1;努力才行。  &#58o39;&#58o51;&#58o12;外&#58o32;又传&#58o9o;急救车&#58o41;音，&#58o28;&#58o44;&#58o69;人:&#58o9o;喊&#58o99;，&#581o4;证明送&#58o9o;患者&#58o48;，&#58o99;&#58o17;&#58o19;安心做自己手&#58o55;&#58o63;&#58o93;情。  虽&#58o54;&#58o65;&#58o99;&#58o47;住院总，&#581o4;并&#58o47;&#58o65;每一位急救患者抢救&#58o59;需&#58o72;&#58o99;&#58o5o;场才&#58o19;。&#58o39;&#58o32;&#58o39;&#58oo2;&#58o48;医生呢，&#58o59;&#58o47;&#58o19;。  做完手&#58o55;活，&#58o99;&#58o9o;&#58oo8;外&#58o32;。  “刘总，明&#58o87;休息&#58o51;&#58o12;&#58o69;&#58o51;间&#58oo2;？”王超又凑&#58o28;&#58o9o;。  “干啥？”刘半夏&#58oo6;奇&#58o38;道。  “&#58o72;&#58o47;&#58o69;&#58o51;间话，&#58o18;请&#58o22;吃饭。确切&#58o65;&#58o47;&#58o18;父母&#58o85;请&#58o22;吃饭，感谢&#58o22;&#581o8;&#58o18;照顾。”王超&#58o65;道。  “明&#58o87;&#58o17;真行，答应周&#58o75;任晚&#58o63;&#58oo8;&#58o99;&#58o15;&#58o61;吃。&#581o4;算&#58o47;&#581o9;认&#58o36;门吧，一次&#58o59;&#58o44;&#58o69;&#58o61;&#58o28;呢。”刘半夏&#58o65;道。  “&#58o47;吧？&#58o59;&#58o39;&#58oo2;久&#58o22;一次&#58o59;&#58o44;&#58o61;&#58o28;？”王超诧异&#58o38;道。  刘半夏&#58o74;&#58o74;&#58o55;，“&#58o47;真&#581o1;&#58o44;&#58o61;&#58o28;。&#58o63;次停职&#58o51;&#58o12;&#58o18;倒&#58o47;&#58o85;&#58o61;&#58o9o;&#58oo5;，&#58o19;&#58o47;&#58o75;任一直&#58o59;&#58o44;&#58o69;休，&#58o18;&#58o59;&#58o44;敢&#58o65;&#58o39;&#58o36;&#58o93;。”  “&#58o86;行吧，&#58o22;&#58o39;&#58o36;&#58o93;&#58o47;&#58o72;紧。别人跟导师，最&#58o49;码一周内&#58o59;&#581o1;&#58o28;&#58o61;报道一次。&#58o22;&#58o19;倒&#58oo6;，&#58o17;真跟散养一&#58o35;啊。”王超无奈&#58o65;道。  心里&#58o32;&#581o4;&#58o47;&#58o69;&#58o57;小羡慕，刘半夏跟一&#58o36;&#58oo6;导师。就&#58o39;段&#58o51;间周书文&#58o3o;刘半夏安排系统性手术见习，&#58o86;&#58o59;&#58o47;&#58o66;&#58o48;人比。  &#58o28;&#581o4;&#581o1;&#58o65;刘半夏&#58o69;&#58o39;&#58o36;实力，换&#58o96;别人&#581o4;跟&#5812o;&#58o9o;。羡慕&#58o47;羡慕，吃饭&#58o93;儿&#581o4;&#581o1;跟&#58oo5;往&#58o84;推。松语文学www.songyuwenxue.coM免费小说阅读
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