Biolato Marco, Vitale Federica, Galasso Tiziano, Gasbarrini Antonio, Grieco Antonio
Department of Medical and Surgical Sciences, CEMAD, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy.
Department of Internal Medicine, Catholic University of Sacred Heart, Rome 00168, Italy.
World J Gastrointest Surg. 2023 Feb 27;15(2):127-141. doi: 10.4240/wjgs.v15.i2.127.
Cirrhotic patients with severe thrombocytopenia are at increased risk of bleeding during invasive procedures. The need for preprocedural prophylaxis aimed at reducing the risk of bleeding in cirrhotic patients with thrombocytopenia who undergo scheduled procedures is assessed the platelet count; however, establishing a minimum threshold considered safe is challenging. A platelet count ≥ 50000/μL is a frequent target, but levels vary by provider, procedure, and specific patient. Over the years, this value has changed several times according to the different guidelines proposed in the literature. According to the latest guidelines, many procedures can be performed at any level of platelet count, which should not necessarily be checked before the procedure. In this review, we aim to investigate and describe how the guidelines have evolved in recent years in the evaluation of the minimum platelet count threshold required to perform different invasive procedures, according to their bleeding risk.
患有严重血小板减少症的肝硬化患者在侵入性操作过程中出血风险增加。对于计划进行手术的血小板减少症肝硬化患者，旨在降低出血风险的术前预防措施的必要性需根据血小板计数来评估；然而，确定一个被认为安全的最低阈值具有挑战性。血小板计数≥50000/μL是一个常见目标，但该数值因医疗服务提供者、手术和特定患者而异。多年来，根据文献中提出的不同指南，这个数值已经改变了好几次。根据最新指南，许多手术可以在任何血小板计数水平下进行，不一定在手术前检查血小板计数。在本综述中，我们旨在研究和描述近年来指南如何根据不同侵入性手术的出血风险，在评估进行这些手术所需的最低血小板计数阈值方面不断演变。
