Boberg K M, Brosstad F, Egeland T, Egge T, Schrumpf E
Medical Department A, Rikshospitalet, Oslo, Norway.
Thromb Haemost. 1999 Mar;81(3):378-81.
Bleeding time determination is not advised as a general preoperative hemostasis screening test, but it might be useful in some patient groups. Patients referred for liver biopsy frequently have coagulation disturbances and are at risk of hemorrhage. In this prospective study 219 liver biopsies were carried out regardless of a prolonged bleeding time, but with minimum requirements for hemoglobin concentration, platelet count, and tests of the internal and external coagulation pathways. The bleeding time was prolonged in the case of 48 (22%) of the biopsies. Significant bleeding as defined by a hemoglobin decrease of > or =2.0 g/dl occurred in nine patients. Three of these patients were bone marrow transplanted. Patients with a prolonged bleeding time carried a five times higher risk of bleeding (odds ratio = 5.0; confidence interval = 1.1-21.8; p = 0.019). We conclude that the bleeding time may give additional information on the risk of bleeding in some patient groups undergoing liver biopsy.
不建议将出血时间测定作为常规的术前止血筛查试验，但在某些患者群体中可能有用。接受肝活检的患者经常存在凝血功能障碍，有出血风险。在这项前瞻性研究中，对219例患者进行了肝活检，无论其出血时间是否延长，但对血红蛋白浓度、血小板计数以及内源性和外源性凝血途径检测有最低要求。48例（22%）活检病例的出血时间延长。9例患者出现了符合血红蛋白下降≥2.0 g/dl定义的明显出血。其中3例患者接受过骨髓移植。出血时间延长的患者出血风险高出5倍（优势比=5.0；置信区间=1.1-21.8；p=0.019）。我们得出结论，出血时间可能会为一些接受肝活检的患者群体的出血风险提供额外信息。
