Schmidt J L, Yaremchuk K L, Mickelson S A
Department of Otolaryngology, Henry Ford Hospital, Detroit, MI 48202.
Henry Ford Hosp Med J. 1990;38(1):33-5.
Preoperative coagulation profile screening is routinely performed in otolaryngology before tonsillectomy and adenoidectomy surgery in the United States. Recently there has been controversy as to whether this routine testing is necessary. To evaluate the need for this testing, we reviewed a series of patients with particular attention to abnormal coagulation profiles. Of 91 consecutive patients undergoing tonsillectomy, adenoidectomy, or both, four had abnormal preoperative coagulation profiles. Of these patients, one had von Willebrand disease, one had hypofibrinoginemia, and two had a transient acquired lupus-like anticoagulant. The latter condition, which causes a temporary prolongation of the activated partial thromboplastin time, is discussed in detail along with a review of the pertinent literature. We conclude that coagulopathies occur frequently enough to justify preoperative screening even in the absence of a positive history.
在美国，扁桃体切除术和腺样体切除术术前常规进行凝血功能筛查。最近，对于这种常规检测是否必要存在争议。为评估这种检测的必要性，我们回顾了一系列患者，特别关注异常凝血功能。在连续接受扁桃体切除术、腺样体切除术或两者手术的91例患者中，4例术前凝血功能异常。这些患者中，1例患有血管性血友病，1例患有低纤维蛋白原血症，2例患有短暂获得性狼疮样抗凝物。本文详细讨论了导致活化部分凝血活酶时间暂时延长的后一种情况，并对相关文献进行了综述。我们得出结论，即使没有阳性病史，凝血障碍的发生频率也足以证明术前筛查是合理的。
