Bhuripanyo K, Khumsuk K, Sornpanya N, Wangsai W, Patoombal N
Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
J Med Assoc Thai. 1995 Jan;78(1):42-7.
Because anemia and infectious diseases are still common, routine preoperative complete blood count (CBC) is often performed in most teaching hospitals in Thailand. However, there is growing consensus that it is of little benefit. We studied prospectively all patients who were scheduled for elective operation in Srinagarind Hospital. Medical history and physical examination were obtained prospectively without knowing the CBC result. Out of 1,013 patients interviewed, 955 were suitable for study, 384/955 (40.2%) of the CBC were abnormal. Significant anemia (hematocrit less than 30%) was found in 42 (4.4%), leukocytosis in 113 (11.8%), inadequate platelet in 3 (0.3%). The CBC abnormalities led to a change in management in 38 (4.0%). The clinical predictors of CBC abnormalities included weight loss, history of fever, presence of anemia and tender abdomen. In those with normal history and physical examination, the prevalence of anemia and CBC which led to management change was less than 1.7 per cent, regardless of age.
由于贫血和传染病仍然很常见,泰国大多数教学医院通常会在术前进行常规全血细胞计数(CBC)检查。然而,越来越多的人达成共识,认为其益处不大。我们对诗琳通医院所有计划进行择期手术的患者进行了前瞻性研究。前瞻性地获取病史和体格检查结果,而不了解CBC结果。在接受访谈的1013名患者中,955名适合研究,其中384/955(40.2%)的CBC结果异常。发现42例(4.4%)有严重贫血(血细胞比容低于30%),113例(11.8%)有白细胞增多,3例(0.3%)血小板不足。CBC异常导致38例(4.0%)治疗方案改变。CBC异常的临床预测因素包括体重减轻、发热史、贫血和腹部压痛。在病史和体格检查正常的患者中,无论年龄大小,贫血和导致治疗方案改变的CBC的患病率均低于1.7%。