Brenner Thorsten, Hofer Stefan
Klinik für Anästhesiologie des Universitätsklinikums Heidelberg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2013 May;48(5):336-45. doi: 10.1055/s-0033-1347158. Epub 2013 Jun 11.
In patients suffering from acute haemorrhages, a prompt, targeted and restrained coagulation management is required. This should be based on a contemporary and sophisticated analysis of the coagulation system. Standard parameters (e.g. prothrombin time, international normalized ratio, plasma levels of fibrinogen, thrombocyte count etc.) seem not to be feasible, since they are hallmarked by a limited diagnostic value as well as a relevant turn around time. Bedside tools of haemostaseological point-of-care-testing (POCT, e.g. viscoelastic and aggregometric POCT) were shown to be superior in this setting. Especially the implementation of POCT-based treatment algorithms for patients suffering from acute haemorrhages was able to improve patient' outcome and resulted in reduced haemotherapy-associated costs.
对于急性出血患者,需要迅速、有针对性且适度的凝血管理。这应基于对凝血系统的现代且精细的分析。标准参数(如凝血酶原时间、国际标准化比值、纤维蛋白原血浆水平、血小板计数等)似乎不可行,因为它们的诊断价值有限且周转时间较长。在这种情况下,床边止血床旁检测工具(POCT,如粘弹性和凝集性POCT)已显示出优势。特别是针对急性出血患者实施基于POCT的治疗算法能够改善患者预后并降低血液治疗相关成本。