Clinica Medica III, Università di Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia.
Thromb Res. 2009 Nov;124(5):e13-8. doi: 10.1016/j.thromres.2009.06.009. Epub 2009 Jul 24.
The optimal management of bleeding or its prophylaxis in patients with disorders of platelet count or function is controversial. The bleeding diathesis of these patients is usually mild to moderate: therefore, transfusion of platelet concentrates may be inappropriate, as potential adverse effects might outweigh its benefit. The availability of several anti-hemorrhagic drugs further compounds this problem, mainly because the efficacy/suitability of the various treatment options in different clinical manifestations is not well defined. In these guidelines, promoted by the Italian Society for Studies on Haemostasis and Thrombosis (Società Italiana per lo Studio dell'Emostasi e della Trombosi [SISET]), we aim at offering the best available evidence to help the physicians involved in the management of patients with disorders of platelet count or function. Literature review and appraisal of available evidence are discussed for different clinical settings and for different available treatments, including platelet concentrates (PC), recombinant activated factor VII, desmopressin, antifibrinolytics, aprotinin and local hemostatic agents.
血小板计数或功能障碍患者的出血或其预防的最佳管理存在争议。这些患者的出血倾向通常为轻至中度：因此，输注血小板浓缩物可能不合适，因为潜在的不良反应可能超过其益处。由于多种止血药物的可用性，进一步加剧了这一问题，主要是因为不同临床表现的各种治疗选择的疗效/适用性尚未明确界定。在这些指南中，由意大利止血和血栓形成研究学会（Società Italiana per lo Studio dell'Emostasi e della Trombosi [SISET]）提出，我们旨在提供最佳可用证据，以帮助管理血小板计数或功能障碍患者的医生。针对不同的临床情况和不同的可用治疗方法，包括血小板浓缩物（PC）、重组活化因子 VII、去氨加压素、抗纤维蛋白溶解剂、抑肽酶和局部止血剂，讨论了文献综述和现有证据的评估。
