Eisenberg J M, Clarke J R, Sussman S A
Arch Surg. 1982 Jan;117(1):48-51. doi: 10.1001/archsurg.1982.01380250030007.
Preoperative tests of coagulation function have been suggested to detect patients who are likely to have abnormal bleeding during and after surgery. A study was designed to determine the yield of prothrombin time (PT) and partial thromboplastin time (PTT), both in discovering patients who are at risk for abnormal bleeding and in inducing changes in patient care or outcome. Of 750 patients on three surgical services, 611 (81%) patients had no indication of a bleeding disorder on history or physical examination. Of the 139 patients who had clinical indications, 25 (18.0%) patients had an abnormal PT or PTT. Of the 611 patients without clinical indications, 480 patients had the PT or PTT determined, and 13 (2.7%) patients had abnormal results. One (0.2%) of the 480 patients might have benefited from the test result (this patient required a second operation to control arterial bleeding). The prolonged PT or PTT was of no apparent clinical importance in the remaining 12 patients without indications of bleeding disorders preoperatively. The low yield of the PT and PTT in detecting unsuspected bleeding disorders preoperatively was further obscured by the larger number of apparently false-positive results.
术前凝血功能检测旨在发现手术期间及术后可能出现异常出血的患者。一项研究旨在确定凝血酶原时间（PT）和部分凝血活酶时间（PTT）的检测价值，包括发现有异常出血风险的患者以及促使患者护理或治疗结果发生改变。在三个外科科室的750例患者中，611例（81%）患者在病史或体格检查中无出血性疾病迹象。在139例有临床指征的患者中，25例（18.0%）患者PT或PTT异常。在611例无临床指征的患者中，480例患者进行了PT或PTT检测，13例（2.7%）患者结果异常。480例患者中有1例（0.2%）可能从检测结果中获益（该患者需要二次手术以控制动脉出血）。术前无出血性疾病迹象的其余12例患者中，PT或PTT延长并无明显临床意义。术前PT和PTT检测未被怀疑的出血性疾病的阳性率较低，且大量明显的假阳性结果进一步掩盖了这一情况。
