Kussmann I, Koller M, Heinke T, Rothmund M
1. Chirurgische Abteilung, Allgemeinen Krankenhauses Wandsbek, Hamburg.
Chirurg. 1997 Jul;68(7):684-8.
Coagulation studies, i.e. platelet count, prothrombin time (PT) and activated partial thrombin time (aPTT) are commonly employed preoperatively to identify patients at risk. In a retrospective study we evaluated the usefulness of these screening tests to predict postoperative bleeding in 1447 patients with abdominal and thoracic surgery. Forty-six patients (3.2%) experienced postsurgical bleeding. 12.2% of our patients had abnormal coagulation studies. The sensitivity of abnormal coagulation studies with respect to postoperative bleeding was 23.9%. The sensitivity of the parameter "patient at risk", i.e. patients with suspected coagulopathies due to drugs or disease of the liver or kidney, was 56.5%. Thirty-four out of 1008 patients without risk factors had abnormal coagulation tests but an uneventful postoperative course. Preoperative screening of PT and aPTT should be reserved for patients with known or suspected inherited or acquired coagulopathies.
凝血检查，即血小板计数、凝血酶原时间（PT）和活化部分凝血活酶时间（aPTT），通常在术前用于识别有风险的患者。在一项回顾性研究中，我们评估了这些筛查试验对1447例腹部和胸部手术患者术后出血的预测作用。46例患者（3.2%）术后出血。我们的患者中有12.2%凝血检查异常。凝血检查异常对术后出血的敏感性为23.9%。“有风险患者”这一参数的敏感性，即因药物或肝肾疾病疑似患有凝血病的患者，为56.5%。1008例无风险因素的患者中有34例凝血检查异常，但术后过程顺利。PT和aPTT的术前筛查应仅用于已知或疑似患有遗传性或获得性凝血病的患者。
