Borges Nuno M, Thachil Jecko
Teaching Fellow in Haematology and Oncology, Department of Haematology, Freeman Hospital, Newcastle upon Tyne NE7 7DN.
Consultant Haematologist, Department of Haematology, Manchester Royal Infirmary, Manchester.
Br J Hosp Med (Lond). 2017 Oct 2;78(10):566-570. doi: 10.12968/hmed.2017.78.10.566.
Coagulation testing has long been part of the routine assessment of the preoperative patient, with the aim of identifying those with a bleeding disorder who might suffer significant perioperative bleeding. Some of the issues surrounding this involve the low prevalence of bleeding disorders in the general population, and the implications of further testing for both the patient and the health-care system. Studies suggest that this practice is not evidence based and is considered to be outdated. Most guidelines now advise against routine coagulation screens before surgery, and instead recommend taking a thorough personal and family history of bleeding in order to determine the need for further investigations. This review analyses current evidence on this topic and provides a comprehensive view of the relevance of preoperative coagulation testing.
长期以来，凝血功能检测一直是术前患者常规评估的一部分，目的是识别那些可能患有出血性疾病并在围手术期发生严重出血的患者。围绕这一问题的一些因素包括出血性疾病在普通人群中的低患病率，以及进一步检测对患者和医疗保健系统的影响。研究表明，这种做法缺乏循证依据，被认为已经过时。现在大多数指南都建议在手术前不要进行常规凝血筛查，而是建议全面了解个人和家族出血史，以确定是否需要进一步检查。本综述分析了关于这一主题的现有证据，并全面阐述了术前凝血检测的相关性。
