Techniques for evaluating the cause of bleeding in the ICU. Diagnostic clues and keys to interpreting hemostatic tests.

The Journal of critical illness Pub Date : 1995-02-01
I Redei, R N Rubin
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引用次数: 0

Abstract

Begin by obtaining both a bleeding and a family history to help ascertain whether the disorder is acquired or inherited. On physical examination, look for multiple bleeding sites or profuse bleeding; these can indicate a systemic bleeding diathesis. Order hemostatic tests. Prolonged aPTT points to a defect in the intrinsic or common coagulation pathway; prolonged PT, to a defect in the extrinsic or common pathway. Thrombin time is abnormal when hypofibrinogenemia, afibrinogenemia, or thrombin inhibitors are present. Bleeding time is prolonged in thrombocytopenia, platelet dysfunction, severe hypofibrinogenemia, and von Willebrand's disease. Factor assays also may be needed to further define the defect.

评估ICU出血原因的技术。解释止血试验的诊断线索和关键。
首先获得出血和家族史,以帮助确定疾病是获得性还是遗传性。体格检查时,寻找多处出血或大量出血;这些可以提示全身性出血。安排止血检查。aPTT延长表明内在或共同凝血途径存在缺陷;由于外源性或共同通路的缺陷而导致的PT延长。凝血酶时间异常时,低纤维蛋白原血症,纤原蛋白原血症,或凝血酶抑制剂存在。在血小板减少症、血小板功能障碍、严重的低纤维蛋白原血症和血管性血友病中,出血时间延长。因子分析也可能需要进一步确定缺陷。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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