Department of Pediatric Hematology, Emma Children's Hospital AMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur J Pediatr. 2012 Feb;171(2):207-14. doi: 10.1007/s00431-011-1571-x. Epub 2011 Sep 17.
Bleeding complications in children may be caused by disorders of secondary hemostasis or fibrinolysis. Characteristic features in medical history and physical examination, especially of hemophilia, are palpable deep hematomas, bleeding in joints and muscles, and recurrent bleedings. A detailed medical and family history combined with a thorough physical examination is essential to distinguish abnormal from normal bleeding and to decide whether it is necessary to perform diagnostic laboratory evaluation. Initial laboratory tests include prothrombin time and activated partial thromboplastin time. Knowledge of the classical coagulation cascade with its intrinsic, extrinsic, and common pathways, is useful to identify potential defects in the coagulation in order to decide which additional coagulation tests should be performed.
儿童出血并发症可能由继发止血或纤溶障碍引起。病史和体格检查的特征表现，尤其是血友病，包括可触及的深部血肿、关节和肌肉出血以及反复出血。详细的病史和家族史结合全面的体格检查对于区分异常出血和正常出血以及确定是否需要进行诊断性实验室评估至关重要。初始实验室检查包括凝血酶原时间和激活的部分凝血活酶时间。了解经典的凝血级联反应及其内在、外在和共同途径有助于识别凝血中的潜在缺陷，以便决定应进行哪些额外的凝血试验。
