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[异常实验室检查结果:合理性、可靠性及影响]

[Abnormal laboratory results : Plausibility, reliability, and implications].

作者信息

Lackner K J, Schellong S M

机构信息

Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.

Medizinische Klinik 2, Städtisches Klinikum Dresden, Campus Friedrichstadt, Dresden, Deutschland.

出版信息

Internist (Berl). 2018 Mar;59(3):234-240. doi: 10.1007/s00108-018-0384-7.

Abstract

In outpatient care or the emergency room laboratory tests oftentimes provide the first clues to the medical condition that made the patient seek medical help. Quite commonly, rapid medical decisions are required in these situations. Therefore, laboratory results must be evaluated immediately and interpreted within the broader context of the patient's presentation. During this process test results must be checked for plausibility, their positive and/or negative predictive values for the individual patient must be considered, and finally, the potential clinical implications need to be assessed. The latter in particular is of the utmost importance. This article discusses several laboratory tests commonly ordered for emergency patients and provides some guidance on their relevance in the decision to refer an outpatient to an emergency room or for inpatient care, or whether a patient can be safely diagnosed in the outpatient setting.

摘要

在门诊护理或急诊室,实验室检查常常能为促使患者寻求医疗帮助的病症提供最初线索。在这些情况下,通常需要迅速做出医疗决策。因此,必须立即评估实验室检查结果,并在患者临床表现的更广泛背景下进行解读。在此过程中,必须检查检查结果的合理性,考虑其对个体患者的阳性和/或阴性预测价值,最后,评估潜在的临床意义。后者尤为重要。本文讨论了几种常用于急诊患者的实验室检查,并就其在决定将门诊患者转诊至急诊室或住院治疗,或患者是否可在门诊环境中安全诊断方面的相关性提供了一些指导。

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