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[血液系统疾病——临床观点述评]

[Hematologic disorders--comments from clinical stand points].

作者信息

Watanabe K

机构信息

Department of Laboratory Medicine, School of Medicine, Keio University, Tokyo.

出版信息

Rinsho Byori. 1995 Jun;43(6):597-600.

PMID:7602806
Abstract

In 1992, a booklet entitled "how the primary physician can effectively use clinical laboratory tests for the initial diagnosis of hematologic disorders" was published under the direction of Members of the Committee of Japan Society of Clinical Pathology. It was very nicely edited and was potentially useful for the tentative initial diagnosis of hematologic diseases. However, the following improvements would make it more practical: 1) The definition of the primary physician should be more clearly described in the text. 2) TIBC rather than UIBC would be more appropriate to use for the diagnosis of microcytic anemias. 3) Bleeding time can be excluded from the screening tests for bleeding tendency, since it is very difficult for practitioners to perform it in their office. 4) Laboratory tests for the diagnosis of patients with anemia and jaundice should be used as a secondary screening rather than primary screening. 5) A chart showing the laboratory guide for the initial diagnosis of anemia, leukocyte abnormality and bleeding tendency would be more helpful. 6) Most of the secondary screening tests described in the text are usually ordered by clinical hematologists, thus being unnecessary to list up in the guide for the primary physician.

摘要

1992年,在日本临床病理学会委员会成员的指导下,出版了一本名为《初级医师如何有效利用临床实验室检查进行血液系统疾病的初步诊断》的小册子。它编辑得非常好,对血液系统疾病的初步诊断可能有用。然而,通过以下改进可以使其更具实用性:1)应在文中更清晰地描述初级医师的定义。2)对于小细胞性贫血的诊断,使用总铁结合力(TIBC)而非未饱和铁结合力(UIBC)更为合适。3)出血时间可从出血倾向的筛查试验中排除,因为从业者在其办公室很难进行此项检查。4)用于诊断贫血和黄疸患者的实验室检查应作为二级筛查而非一级筛查。5)一张显示贫血、白细胞异常和出血倾向初步诊断的实验室指南图表会更有帮助。6)文中描述的大多数二级筛查试验通常由临床血液学家开具,因此无需在初级医师指南中列出。

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