体温单要怎么样设计?--怎么样供给给医生有价值的信息
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">昨天<span style="color: black;">夜晚</span>,有位同道在网上咨询我一个案例的诊治问题,这位有脑胶质瘤病史的<span style="color: black;">病人</span>,<span style="color: black;">长时间</span>在家卧床,<span style="color: black;">由于</span>“发热、咳嗽、痰1天”来就诊。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-axegupay5k/014b3f943148469b80571855b68e169c~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=FTYcKdm6NTQvemNrRUprjoVp8Ss%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">病人</span>的白细胞总数和中性粒细胞比例均<span style="color: black;">升高</span>,C反应蛋白<span style="color: black;">亦</span>略有<span style="color: black;">升高</span>,但胸片<span style="color: black;">检测</span>无<span style="color: black;">显著</span><span style="color: black;">反常</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-tjoges91tu/f70b5e472465ee3151236538598cee1b~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=%2FRkA3XC%2Fd8zKbbTBbDUKQP0rm4w%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">有意思的是体温单,初看体温和脉搏曲线<span style="color: black;">显著</span>的分离,我当时还<span style="color: black;">思虑</span><span style="color: black;">是不是</span>存在相对缓脉,以及<span style="color: black;">引起</span>相对缓脉的某些特殊感染。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-tjoges91tu/5cb833968dc4910543234a6edb5560cb~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=%2BEBwT96Cm2byOvoJ4JBtb1d0yh4%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">什么是相对缓脉呢?<span style="color: black;">随着体温的<span style="color: black;">上升</span>,脉搏呈现出为<span style="color: black;">持续</span><span style="color: black;">提升</span>的趋势,<span style="color: black;">一般</span>体温和脉率是有对应关系(见下表),相对缓脉<span style="color: black;">指的是</span>脉率在对应脉率<span style="color: black;">基本</span>上减少<span style="color: black;">最少</span>10次/分,<span style="color: black;">能够</span>采用下表来简单估计。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-tjoges91tu/ea2872411268c21050e84ba0c8a30a4b~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=OJCvz3jTM5GxnbvLGjzh5d8tFlY%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">相对缓脉多见于以下<span style="color: black;">疾患</span>:</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-tjoges91tu/33fea111ff8a5101b3012c5375a52254~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=kwo%2BVAWGujUFdRNHGc1aNl%2F6PkY%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">因此</span>一旦有相对缓脉,<span style="color: black;">针对</span><span style="color: black;">咱们</span>诊断是有<span style="color: black;">帮忙</span>的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">然则</span>,我认真一看,<span style="color: black;">发掘</span>其实<span style="color: black;">病人</span>并<span style="color: black;">无</span>相对缓脉,认真看体温表左侧边栏上,<span style="color: black;">呼气</span>、脉搏和体温的对应关系。脉搏100次/分对应体温36摄氏度,脉搏120次/分对应体温37摄氏度,脉搏140次/分对应体温38摄氏度。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-tjoges91tu/9ba9c770a74561554076a809d71940e8~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=CtfXqKEAsQwIHvo5ccC2cKZTc1c%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">大众</span><span style="color: black;">能够</span>再<span style="color: black;">瞧瞧</span><span style="color: black;">咱们</span>医院的体温单侧边栏,脉搏60次/分对应的是体温37摄氏度,脉搏80次/分对应的体温38摄氏度,脉搏100次/分对应体温是39度,<span style="color: black;">脉搏120次/分对应体温是40度。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://p3-sign.toutiaoimg.com/tos-cn-i-tjoges91tu/b43afc4c20e5d9cb00285f36bd499eb0~noop.image?_iz=58558&from=article.pc_detail&lk3s=953192f4&x-expires=1726091231&x-signature=WMX2gpcLzC%2F7fP%2FsSPwtnjnHnZ4%3D" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">显然,<span style="color: black;">咱们</span>医院的这种体温表设计可符合临床<span style="color: black;">状况</span>,虽然不可能所有人都是<span style="color: black;">这般</span>一一对应,例如有些人体温38度的时候可能脉搏就到了100次/分,<span style="color: black;">然则</span><span style="color: black;">咱们</span>仍然<span style="color: black;">能够</span>大致看出两者的<span style="color: black;">关联</span>性。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">我在《<span style="color: black;">教你学会看体温单—<span style="color: black;">怎样</span>抓住关键信息</span>》、《<span style="color: black;"><span style="color: black;">怎样</span>从体温单来推测发热的<span style="color: black;">原由</span></span>》、《<span style="color: black;">体温单--一个被<span style="color: black;">咱们</span>遗忘的临床信息表之一</span>》中举过几个案例<span style="color: black;">来讲</span>明<span style="color: black;">怎样</span>从体温单上去收集线索分析病因。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">以发热的案例<span style="color: black;">来讲</span>明,<span style="color: black;">倘若</span>设计好的体温表,<span style="color: black;">咱们</span>能够快速判断体温与脉搏的<span style="color: black;">关联</span>性,<span style="color: black;">然则</span>设计<span style="color: black;">欠好</span>的体温表,<span style="color: black;">咱们</span>还要去想一想,<span style="color: black;">不可</span>直观地做出判断。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">之<span style="color: black;">因此</span>有些医院采取将体温和脉搏完全分离的这种设计模式,<span style="color: black;">据述</span>是<span style="color: black;">由于</span>以前采取手工画图,护士容易把两条曲线重合,<span style="color: black;">不易</span>分清,<span style="color: black;">因此呢</span>为了将体温曲线和脉搏曲线完全分清,就将纵坐标值进行<span style="color: black;">这般</span>的设计。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">不外</span>,<span style="color: black;">此刻</span><span style="color: black;">已然</span>进行无纸化操作,<span style="color: black;">经过</span>电脑打入数据,电脑自动生成,已不太会<span style="color: black;">显现</span>人为画图可能<span style="color: black;">引起</span>的错误,<span style="color: black;">因此呢</span>完全<span style="color: black;">不消</span>故意而为之,还是回归正常的标尺更为合适。</p>
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你的话语如春风拂面,让我感到无比温暖。
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