Adam Elisabeth Hannah, Füllenbach Christoph, Lindau Simone, Konczalla Jürgen
Anasthesiol Intensivmed Notfallmed Schmerzther. 2018 Jun;53(6):425-439. doi: 10.1055/s-0043-107754. Epub 2018 Jun 26.
Disorders of the coagulation system can seriously impact the clinical course and outcome of neurosurgical patients. Due to the anatomical location of the central nervous system within the closed skull, bleeding complications can lead to devastating consequences such as an increase in intracranial pressure or enlargement of intracranial hematoma. Point-of-care (POC) devices for the testing of haemostatic parameters have been implemented in various fields of medicine. Major advantages of these devices are that results are available quickly and that analysis can be performed at the bedside, directly affecting patient management. POC devices allow identification of increased bleeding tendencies and therefore may enable an assessment of hemorrhagic risks in neurosurgical patients. Although data regarding the use of POC testing in neurosurgical patients are limited, they suggest that coagulation testing and hemostatic therapy using POC devices might have beneficial effects in this patient population. This article provides an overview of the application of point-of-care coagulation testing in clinical practice in neurosurgical patients.
凝血系统紊乱会严重影响神经外科患者的临床病程和预后。由于中枢神经系统位于封闭的颅骨内，出血并发症可能导致诸如颅内压升高或颅内血肿扩大等灾难性后果。用于检测止血参数的床旁检测（POC）设备已在医学的各个领域得到应用。这些设备的主要优点是结果可快速获得，并且可以在床边进行分析，直接影响患者的管理。POC设备能够识别出血倾向增加的情况，因此可以对神经外科患者的出血风险进行评估。尽管关于在神经外科患者中使用POC检测的数据有限，但这些数据表明，使用POC设备进行凝血检测和止血治疗可能对该患者群体有有益影响。本文概述了床旁凝血检测在神经外科患者临床实践中的应用。
