匹兹堡医护前线（2025）

The Pitt S02E03

Part 5 Feb. 14, 2026, 6:09 p.m.

我得问一句你为什么要把珠子塞进鼻子
I got to ask-- why'd you stick them up there?
想看看多少颗能塞满吗
See how many will fit?
为了像火箭一样把它们发射出去
To shoot them out like rockets.
但我不小心把它们吸进去了到了更深的地方
But I breathed in, and they went deeper
出不来了
and now won't come out.
你在家试过什么方法吗
Did you try anything at home?
是的我尝试往他嘴里吹气但给自己弄了一脸鼻涕
Yeah, I tried blowing in his mouth, but just got a little snot on my cheek.
精神可嘉爸爸
"A" for effort, Dad.
好的我们要用这个小手电筒看下里面好吗
Okay, we need to take a look with a little flashlight. Okay?
好的
Okay.
这就是我即将面对的生活吗
This is what I have to look forward to?
这才哪到哪
This and so much more.
下鼻甲下方有颗红色珠子
Red bead below the inferior turbinate.
我这边…有颗蓝色的
I... got a blue one.
阿氟林苯佐卡因卡兹吸血器
Afrin, benzocaine, Katz extractor?
对孩子爸爸看来我们得把它们取出来了
Yep. Dad, looks like we got to go up and get them.
他一刻都不老实
No way he's sitting still.
他会被麻醉的 - 你不了解这孩子
Oh, he'll be numbed up. - You don't know this child.
嘿杜安特
Hey, Duante,
你喜欢电子游戏吗
you like video games?
所有人都喜欢
Everybody does.
我们有个3D版的电子游戏
We have a 3D video game.
是的 - 好酷
Yeah. - Cool.
正在输注每小时10毫当量的氯化钾生理盐水
That's KCl and saline at 10 MEQ per hour.
我们避免使用葡萄糖
We avoid dextrose
因为胰岛素效应会导致血钾进一步降低
because the insulin response drops the K even more.
如果是遗传病为什么他小时候没发病
If it's genetic, why didn't it happen when he was a kid?
这种病一般在青春期后才会显现 - 而且可能间歇性发作
It usually starts after the teen years. - And it can be intermittent.
有时剧烈运动或压力会触发
Sometimes it's triggered by intense exercise or stress.
我们结婚八年了我们吵过架但他从未倒地不起
We've been married eight years. We've had fights. He's never collapsed.
如果他有甲亢的话也可能在后期发病
If his thyroid gets overactive, that brings it on later in life.
我开了促甲状腺激素 T3和T4的检查
I ordered TSH, T3, T4.
所以我们现在只能等待
So now we just wait?
上呼吸球囊开始按压充电到200焦耳
Bag him. Starting compressions. Charge to 200.
怎么回事
What is happening?
低血钾会损害心脏的
Low potassium can harm electrical activity
电活动 - 充电完毕
in the heart. - Charged.
清场 - 清场
Clear. - Clear.
恢复按压
Resuming compressions.
所以你那个病人是ITP
So your little girl was ITP?
没想到吧
Go figure.
没有什么比一大早来个罕见病更提神醒脑的了
Nothing like a zebra to kick-start your morning.
至少比另一种可能性要好 - 那倒是
Well, it's better than the alternative. - True.
ITP
ITP.
全称是…
So that's, uh, intra--
免疫性血小板减少症
Immune thrombocytopenia.
以前叫做“原发性血小板减少性紫癜”
Used to be called idiopathic thrombocytopenic purpura.
知道“原发性”是什么意思吗
Know what "idiopathic" means?
意思是我们不知道具体的病因
That we don't know the exact cause.
意思是病人很可怜
It means the patient is pathetic
医生是白♥痴♥
and the doctor is an idiot.
我刚看过无名氏婴儿了
Just checked on baby Jane Doe.
状态良好喝奶粉也喝得很好
Looking good. Taking formula well.
我们是来做笔录的
We're here to take a statement.
我们找托尼·钦奇奥洛
We're looking for a Tony Chinchiolo.
哟我在这儿呢兄弟们
Yo! Right over here, boys!
或者警官们
Well, officers.
听说你在学校图书馆遇到了麻烦
Heard you had some trouble over at the campus library.
该死的这么说吧
Shit. Let me just say--
我对你们的日常工作有了新的认识
new appreciation for what you guys do every day.
简直是他妈的瘾君子丛林对吧
Frickin' junkie jungle, right?
在学校图书馆 - 是的
At the campus library? - Yeah.
拇指与食指呈C状
Thumb and forefinger make a C.
其余三指呈E形托住下颌
Bottom three fingers make an E for jaw lift.
每五秒钟呼吸一次来你试试
One breath every five seconds. Come here, try it.
除颤后大约两分钟
About two minutes since defibrillation.
停止按压
Holding compressions.
窦性心律正常
Normal sinus.
颈动脉搏动有力好的准备测血压
Carotid. Strong carotid. Okay, let's try for BP.
我们为什么不等电击后再测
Why don't we check after the shock?
依据2024版高级心脏生命支持指南
2024 ACLS guidelines.
即便除颤成功
Patients can remain pulseless for a little bit,
病人仍可能短时间无脉搏
even after successful defib.
他电击一次就恢复心跳了这已经是最理想的情况了
He came back with one shock. That's as good as it gets.
高压104 低压68 - 心脏收缩有力射血分数良好
104 over 68. - Good squeeze. Good EF.
恢复自主呼吸了好的我们…
Spontaneous respirations. Okay, let's lift him up.
他能自己呼吸了
He's breathing on his own--
这是好迹象 - 天啊
excellent sign. - Oh, God.
我能摸摸他吗 - 当然
Can I touch him? - Of course.
嗨马克
Oh, Mark.
嘿
Hey.
糟了
Oh, shit.
推个轮床过来
We need a gurney!
南希
Nancy?
易太太
Mrs. Yee?
易太太
颈动脉搏动无力呼吸浅弱
Weak carotid. Shallow breaths.
她是因为压力太大导致昏厥了吗
Did she vasovagal from stress?
不能做这种假定有安全带勒痕…
Can't assume that. Positive seat belt si--
该死
oh, shit.
挂两袋O型阴性血通知加西亚医生
Hang two units of O-neg on the rapid infuser. Somebody call Garcia.
该死我们应该坚持给她做检查的
Shit. We really should have insisted on examining her.
好了我托住她的头了
Okay, I got the head.
血小板是血液里的小颗粒能帮助凝血
Platelets are these tiny things in the blood that help it clot.
而血小板减少症就是 “血小板低”的专业说法
And thrombocytopenia is fancy for "low platelets,"
这就解释了你的皮肤为什么这么容易淤青
which explains why your skin bruises so easily.
是什么原因导致的
And what causes it?
其实是她的免疫系统在摧毁血小板
It's actually her immune system that's causing the destruction of platelets.
有时是环境因素或病毒触发的免疫反应
Sometimes it's a triggered response to, uh, an environmental factor or virus.
那要怎么治疗你们给她用什么药
And what's the treatment? What are you giving her?
我们会用大剂量类固醇
We'll be treating her with high-dose steroids
抑制免疫反应
to suppress the immune system
并静脉注射免疫球蛋白
and IV immunoglobulin,
以减少脾脏对血小板的破坏
which reduces the destruction of the platelets in the spleen.
我能回家吗
Can I go home?
你需要住院三天
You're gonna have to stay in the hospital for about three days
以确保治疗有效
to make sure that the treatment is working.
好吧
Okay. Okay.
那她什么时候能有个病房♥
So when can she get a room in the hospital?
这是个好问题
That is an excellent question.
我去看看能不能尽快给她找一个房♥间
I'm going to see if I can make that happen sooner rather than later,
但可能得等上一段时间 - 好的
but it might take a while. - Okay.
导航说我11点前能到
GPS says I should be there by 11:00.
你还有别的问题吗女士
Do you have any other questions for me, ma'am?
暂时没有了但后续肯定会有你先去忙吧
No. I'm sure I will, but I'll let you go for now.
谢谢本尼 - 好的一会儿医院见
Thank you, Benny. - All right. I'll see you when you get here.
一会见宝贝我爱你
See you soon, baby. I love you.
再见妈妈我也爱你
Bye, Mom. Love you too.
你在这儿啊
There you are.
你也在这儿
And there you are.
别想蒙混过关你答应过我不乱走的
Don't try to charm me. You promised to stay put.
我正打算回去
I was going to come right back.
我的屁♥股♥疼得要命
My backside is killing me.
我必须一直走动不然就会酸疼僵硬
I need to keep moving, or I get all achy and stiff.
我给你拿来了这个泡沫坐垫你可以坐着等X光片
Well, I got you this foam donut to sit on while we wait for your X-rays.
褐眼医生这上面说
Dr. Hazel Eyes, it says here
X光只需要等一到两个小时
that it's only supposed to take an hour or two for an X-ray.
节日版的患者护照能更好地反映现实
Well, the patient passport holiday edition would better reflect reality.
实际时间可能会翻倍
It could be double that.
无需理会现实
There's no need for reality.
我们浪漫主义者…