第四十一章 你的补液方案是错的(2 / 2)

“嗯,训练营见。”唐楼也没有继续搭讪的意思,社会笑了下,便是走出了值班室。

紧跟着,程思思也抄起文件夹子,迈着大长腿走向了病房。

“踏踏踏!”

突然楼道里吗,一阵急促的脚步声从前房传来,一个小护士跑了过来,边跑,便对着程思思喊道:“小程医生,40床病人需要补液,刘教授的电话没有打通,你来看一下,定一个补液方案。”

“补液方案?”

程思思眉头一皱,补液就是给患者补充丢失的液体量,比如发热,上吐下泻,各种造瘘,胃肠减压等等,丢失了多少液体就要补充多少。

当然,补液不仅仅是简单补充下生理盐水,还要补钾,补钙,氨基酸等等,总之是一个需要精确计算的烧脑事情。

“行吧,带我去看看。”

程思思虽然是一个学霸,但是毕竟是一个实习生,对于补液只是在课堂上学过,知道正常值。

“其实也就是照着标准值,往这个数值调呗。”

程思思安慰了自己一下,便是跟着小护士走向了40床。

“补液么?不愧是第一医院,能够遇到各种情况。”

唐楼也是很感兴趣,也是第一次遇到补液的病例,作为医生的本能便是跟了上去。

程思思自然是注意到了唐楼,有些意外的看向他:“你还不回去么?”

“小程医生,你知道我也是医学生,还是第一次碰到补液的病例,所以想要见识见识,不介意吧。”

唐楼诚恳的询问。

“嗯,走吧。那你就一边看着。”程思思虽然也是第一次,不过在自己的地盘总不能弱了气势,一副大姐大的样子,带乡下的小弟弟见见世面。

很快便是走到了40床,患者是一个63岁的大叔,刚做完腹腔镜远端胃癌根治术,在手术中体液丢失,不久前又进行了肝下引流,所以急需要补充体液。

“患者病历。”

程思思脸色有些凝重,这个病患的情况有些复杂,小护士拿上病历,程思思便是仔细的看了起来。

而一旁唐楼,也是一眼看了过去:

【患者:周舟,男63岁

症状:术前预防抗生素100ml,术中补液1100ml,术中丢失体液约:300ml,术后体温升高,体温39.5℃,肝下引流见350ml淡血性液体,留置导尿管可见800ml淡黄色尿液

诊断:患者急需补液,方案如下:

液体量为 48x80+[(39.5-37)x4x80+350+300]2-100-1100 = 3365 ml;

补钠{[(142-120)x80x0.6]17}3 = 21(g);

补钾中度缺钾补 10 g;

葡萄糖日需量 160 g;

氨基酸 96 g;

甘油三酯 56 g。

需要 1 支 10 ml 的微量元素注射液

特别注意:1.体温大于37℃,每升高一度,多补3~5ml/Kg,2.首日按照丢失量1/2补充,否则患者心脏扛不住。】

...

...

程思思将病例还给小护士之后,便是在查房的纸张上计算了起来,沙沙沙,五分钟后,终于得出了答案,不过有些不是很确定。

看着纸张上的方案,正在犹豫要不要按这个的时候,耳边传来了一道磁性的声音,从容又确信:

“小程医生,你这个方案是错误的,这么补液患者会受不了的!”

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