Department of Haematology, Addenbrooke's Hospital, Cambridge, UK.
Br J Haematol. 2010 Sep;150(5):501-14. doi: 10.1111/j.1365-2141.2010.08223.x. Epub 2010 Jul 7.
Point-of-care testing (POCT) in haematology has seen a significant increase in both the spectrum of tests available and the number of tests performed annually. POCT is frequently undertaken with the belief that this will reduce the turnaround time for results and so improve patient care. The most obvious example of POCT in haemostasis is the out-of-hospital monitoring of the International Normalized Ratio in patients receiving a vitamin K antagonist, such as warfarin. Other areas include the use of the Activated Clotting Time to monitor anticoagulation for patients on cardio-pulmonary bypass, platelet function testing to identify patients with apparent aspirin or clopidogrel resistance and thrombelastography to guide blood product replacement during cardiac and hepatic surgery. In contrast to laboratory testing, POCT is frequently undertaken by untrained or semi-trained individuals and in many cases is not subject to the same strict quality control programmes that exist in the central laboratory. Although external quality assessment programmes do exist for some POCT assays these are still relatively few. The use of POCT in haematology, particularly in the field of haemostasis, is likely to expand and it is important that systems are in place to ensure that the generated results are accurate and precise.
床边检测（POCT）在血液学领域中，无论是可进行的检测范围还是每年进行的检测数量都有显著增加。人们普遍认为 POCT 可以缩短结果周转时间，从而改善患者的护理，因此频繁进行 POCT。在止血方面，最明显的 POCT 例子是在接受维生素 K 拮抗剂（如华法林）的患者中进行的院外国际标准化比值监测。其他领域包括使用激活凝血时间监测体外循环患者的抗凝情况、血小板功能测试以确定明显阿司匹林或氯吡格雷抵抗的患者，以及血栓弹力图以指导心脏和肝脏手术中的血液制品替代。与实验室检测相比，POCT 通常由未经培训或半培训的人员进行，并且在许多情况下不受中央实验室存在的相同严格质量控制程序的限制。尽管一些 POCT 检测确实存在外部质量评估计划，但这些计划仍然相对较少。POCT 在血液学中的应用，特别是在止血领域，可能会扩大，因此建立系统以确保生成的结果准确和精确非常重要。
