Hett D A, Walker D, Pilkington S N, Smith D C
Shackleton Department of Anaesthesia, Southampton General Hospital.
Br J Anaesth. 1995 Dec;75(6):771-6. doi: 10.1093/bja/75.6.771.
Assessment of perioperative bleeding disorders, especially those related to platelet dysfunction, remains a clinical challenge. The management of the bleeding patient in the operating theatre or on the postoperative ward is often empirical with little scientific basis. Much of the reason for this is that conventional clotting studies are not immediately available and there is a perceived urgency, particularly among trainee doctors, to treat bleeding disorders without first establishing the exact nature of the coagulopathy. SCT provides useful information on platelet function, particularly in patients after cardiopulmonary bypass, and has enabled practitioners to rationalize the management of bleeding disorders and not expose their patients to the risks of unnecessary transfusion of blood products. Undoubtedly further studies are required before this instrument can be used reliably in the clinical setting but it may prove to be a useful addition to the available techniques for monitoring perioperative bleeding disorders.
围手术期出血性疾病的评估，尤其是那些与血小板功能障碍相关的疾病，仍然是一项临床挑战。在手术室或术后病房对出血患者的处理往往是经验性的，缺乏科学依据。造成这种情况的很大一部分原因是传统凝血研究结果不能立即获得，而且存在一种紧迫感，尤其是在实习医生中，他们在未首先确定凝血病的确切性质的情况下就急于治疗出血性疾病。旋转血栓弹力图（SCT）提供了有关血小板功能的有用信息，特别是在体外循环后的患者中，并且使从业者能够合理地处理出血性疾病，而不会让患者面临不必要输血制品的风险。毫无疑问，在该仪器能够在临床环境中可靠使用之前，还需要进一步研究，但它可能会被证明是现有监测围手术期出血性疾病技术的一个有用补充。
