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4岁娃发热输液15天、换了3种抗生素，怎么还不见好？

2020-07-21 徐灵敏 医学界儿科频道

儿童药物热
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家长总是想着给孩子最好的治疗， 但有时“多”不一定就是“好”。

病例诊疗经过 儿科医生：您好，孩子多大了？怎么不舒服了？ 儿童家长：医生您好，孩子4岁，发热15天了，前边已经看了3家医院，住院2次了，每天都输好几瓶液体，已经输液15天了，咋仍不见好呢？！ 儿科医生：发热15天了，输液用了多种药物治疗仍不见好，确实应该好好回顾下诊疗经过。您把孩子这段时间的就诊经过和治疗情况再详细地说下，把之前的病历和化验检查资料给我看看，我们一起分析判断下孩子发热的原因。 儿童家长：孩子15天前出现发热，同时有点咳嗽、流鼻涕、头痛、吃饭不好，体温高到39℃以上，我们马上就去医院看了。医生说是咽喉部发炎了，给化验了血象，不高，但孩子体温太高，吃药又困难，怕耽误病情，就输液了，每天输液3瓶，有头孢和中药。 输液3天后有点好转，体温正常了，医生说可以吃药再巩固2天，我们说孩子不吃药，就再输液2天巩固吧。继续输液2天后，也就是总共输液5天后，孩子又发热了，第一家医院的医生说还要再抽血化验、拍胸片等等。 可是，孩子咳嗽也不重，呼吸好好的，拍啥胸片呀？！ 我们就又换了一家医院，医生看看孩子的病历、听听胸部后，说“胸片可以暂时不拍，但血要查，还要再查个尿。” 查出来血象比发热第一

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  1. [GetPortalCommentsPageByObjectIdResponse(id=949621, encodeId=cb589496216d, content=小孩发热不建议过早使用抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a37e5423044, createdName=ms6000000252401279, createdTime=Fri Mar 19 23:25:50 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915083, encodeId=16ae91508309, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sat Jan 09 22:16:18 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803650, encodeId=d698803650d3, content=儿童的发热原因有很多种，输液的发热，药物发热，甚至还有一些精神因素的发热。<a href='/topic/show?id=14193e88235' target=_blank style='color:#2F92EE;'>#发热#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37882, encryptionId=14193e88235, topicName=发热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:08:00 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803649, encodeId=e3bf803649cd, content=<a href='/topic/show?id=2c888e81012' target=_blank style='color:#2F92EE;'>#药物热#</a>药物热在临床上面可能被忽视，非常值得医生关注和重视。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87810, encryptionId=2c888e81012, topicName=药物热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:07:29 CST 2020, time=2020-07-21, status=1, ipAttribution=)]
    2021-03-19 ms6000000252401279

    小孩发热不建议过早使用抗生素

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=949621, encodeId=cb589496216d, content=小孩发热不建议过早使用抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a37e5423044, createdName=ms6000000252401279, createdTime=Fri Mar 19 23:25:50 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915083, encodeId=16ae91508309, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sat Jan 09 22:16:18 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803650, encodeId=d698803650d3, content=儿童的发热原因有很多种，输液的发热，药物发热，甚至还有一些精神因素的发热。<a href='/topic/show?id=14193e88235' target=_blank style='color:#2F92EE;'>#发热#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37882, encryptionId=14193e88235, topicName=发热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:08:00 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803649, encodeId=e3bf803649cd, content=<a href='/topic/show?id=2c888e81012' target=_blank style='color:#2F92EE;'>#药物热#</a>药物热在临床上面可能被忽视，非常值得医生关注和重视。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87810, encryptionId=2c888e81012, topicName=药物热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:07:29 CST 2020, time=2020-07-21, status=1, ipAttribution=)]
    2021-01-09 zb1235672

    学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=949621, encodeId=cb589496216d, content=小孩发热不建议过早使用抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a37e5423044, createdName=ms6000000252401279, createdTime=Fri Mar 19 23:25:50 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915083, encodeId=16ae91508309, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sat Jan 09 22:16:18 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803650, encodeId=d698803650d3, content=儿童的发热原因有很多种，输液的发热，药物发热，甚至还有一些精神因素的发热。<a href='/topic/show?id=14193e88235' target=_blank style='color:#2F92EE;'>#发热#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37882, encryptionId=14193e88235, topicName=发热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:08:00 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803649, encodeId=e3bf803649cd, content=<a href='/topic/show?id=2c888e81012' target=_blank style='color:#2F92EE;'>#药物热#</a>药物热在临床上面可能被忽视，非常值得医生关注和重视。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87810, encryptionId=2c888e81012, topicName=药物热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:07:29 CST 2020, time=2020-07-21, status=1, ipAttribution=)]
    2020-07-21 lovetcm

    儿童的发热原因有很多种，输液的发热，药物发热，甚至还有一些精神因素的发热。#发热#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=949621, encodeId=cb589496216d, content=小孩发热不建议过早使用抗生素, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a37e5423044, createdName=ms6000000252401279, createdTime=Fri Mar 19 23:25:50 CST 2021, time=2021-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=915083, encodeId=16ae91508309, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=59321624668, createdName=zb1235672, createdTime=Sat Jan 09 22:16:18 CST 2021, time=2021-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803650, encodeId=d698803650d3, content=儿童的发热原因有很多种，输液的发热，药物发热，甚至还有一些精神因素的发热。<a href='/topic/show?id=14193e88235' target=_blank style='color:#2F92EE;'>#发热#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=37882, encryptionId=14193e88235, topicName=发热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:08:00 CST 2020, time=2020-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=803649, encodeId=e3bf803649cd, content=<a href='/topic/show?id=2c888e81012' target=_blank style='color:#2F92EE;'>#药物热#</a>药物热在临床上面可能被忽视，非常值得医生关注和重视。, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87810, encryptionId=2c888e81012, topicName=药物热)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Tue Jul 21 10:07:29 CST 2020, time=2020-07-21, status=1, ipAttribution=)]
    2020-07-21 lovetcm

    #药物热#药物热在临床上面可能被忽视，非常值得医生关注和重视。

    0