第五十章 小刀的烟花烫
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第五十章小刀的烟花烫
看到这老头咳嗽气急的表现，徐泽就大概地估计出了是个什么病，所以心头却是也大定，如果都是这样明显的病人，那么就算是二十个，也并不会是太辛苦的事情，应该不会轻易地就被电击才是；想起电击时那蚀骨的滋味，徐泽不禁地打了个寒颤。更多小说ltxs520.com
首先通过详细的问诊，这个老头既往有数十年的吸烟史，而且近五、六年来，每于冬春二季，频繁发作咳嗽咳痰，最近的这一两年，开始出现气急。
而体格检查方面，患者张口呼吸，嘴唇发绀，这是明显的缺氧表现；颈动脉怒张、双侧胸廓扩大，肋间隙增宽，双肺呼吸音低，可闻及明显的水泡样湿罗音和哮鸣音，这个应该是有气管炎并感染、还有肺气肿。而且不单是肺部有问题，而且叩诊心脏似乎有扩大。
徐泽想了想，虽然自己在学校还没有系统的学过内科学，但最近小刀教给的内科学上，很清楚的有这种情况的介绍，咳嗽咳痰气急，并有发绀表现，结合体格检查，很明显地可以肯定有慢性支气管炎并有肺气肿，而且心脏也有扩大的话，还得考虑有肺源性心脏病。
想到这里，徐泽启动了x光透视，对病人的肺部进行了进一步的检查。
双肺明显的透气度增高，大部分呈深灰色，而且可以看到斑片装的阴影，心脏比普通人的心脏扩大了不少。
当下徐泽就明确了诊断，自信地对着旁边的小刀道：“诊断考虑慢性支气管炎并感染、阻塞性肺气肿、肺源性心脏病，没有错吧！”
看得徐泽一脸的自得，小刀轻笑了一声，只见得一道电花一闪，徐泽面色一变、惊呼了一声，然后纷身一阵不自主的颤动，头发再次被小刀免费地做了一个烟花烫，烫得很是漂亮那种。
感受着方才那种令人难忘的酥麻味道，徐泽颤抖着嘴唇，愤然地看着小刀道：“小刀，你做什么呢？明明我答对了！”
看着徐泽满脸的愤然，小刀耸了耸肩，轻笑了笑，道：“你答的没错，不过你还有答全面。”
“作为一个医生，你忘记了什么叫全面的体格检查么？什么叫细心么？”小刀一脸的不屑，教训道：“这几个诊断，凭症状谁都能分析出来，但是你忘记了，你刚才没跟他测血压，他的实际血压有180/120mmhg，你说你是不是犯了一个极大的错误？”
“呃……..”听得小刀教训的话语，徐泽这下可是无话可说了，刚才自己确实太大意了，以为诊断很简单，就一时大意，忘记了测血压这个步骤，当下只得低着头，服气地道：“应该加上高血压病3级（极高危组）；对，这次是我错了。”
“嗯……”见得徐泽虚心接受，小刀教授这才满意地点了点头，继续道：“好，继续说他的治疗方案。”
徐泽这下可就认真多了，好好地想了一下，才小心地道：“给予持续低流量低浓度输氧、并予以抗感染、化痰止咳、解痉平喘、改善肺循环、将血压治疗……”
“具体用药？”
听得小刀说出的这句话，徐泽总算是松了口气，看来没有说错，赶紧继续道：“抗生素现在一般选用头孢哌酮钠加苯唑青霉素，并予以氨茶碱、沐舒坦解痉平喘化痰止咳，多巴胺、立其丁改善肺循环，选用波依定降血压。”说罢，赶紧看着小刀，生怕自己出错。
不过还好，小刀教授对他的这次答案极为满意，点头笑道：“嗯……不错，开始正式治疗吧！”说罢，一挥手，徐泽的身前便多了一块医嘱光板和一支激光笔。
既然小刀已经认可了自己的治疗方案，徐泽这下也就放心地开医嘱了，只要大方向不错，哪么这个应该不会出太多问题。
随着徐泽将所有医嘱开完，小刀笑着点头，指着中间的老头道：“好……现在来看看你第一天的治疗情况，你再去检查一下。”
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