{"title":"初级保健中的止血:入门。","authors":"Kevin E Todd","doi":"10.1016/j.cppeds.2025.101762","DOIUrl":null,"url":null,"abstract":"<p><p>Bleeding symptoms in children create significant concern for families and pediatricians alike. This article aims to assist primary care providers in the evaluation of children with bleeding symptoms by reviewing the complexities inherent in diagnosing pediatric bleeding disorders, emphasizing the variability in clinical presentations, testing nuances, and aspects of common bleeding diatheses. The incidence of bleeding disorders among pediatric patients referred for bleeding symptoms and abnormal hemostatic screening remains variable, ranging from 4 % to 11 % across different institutions. A meticulous evaluation-including family history, medication review, and assessment of bleeding severity-is an essential first step in identifying potential bleeding disorders. In patients with a high index of suspicion we recommend screening testing including a complete blood count including blood smear for review, activated partial thromboplastin time (aPTT), prothrombin time (PT), von Willebrand factor (VWF) antigen and activity, and fibrinogen level. Common bleeding disorders in pediatrics include factor deficiencies (including von Willebrand disease) and platelet disorders. A collaborative approach between primary care providers and hematologists is paramount to optimizing outcomes for pediatric patients with bleeding symptoms.</p>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":" ","pages":"101762"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hemostasis in primary care: A primer.\",\"authors\":\"Kevin E Todd\",\"doi\":\"10.1016/j.cppeds.2025.101762\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Bleeding symptoms in children create significant concern for families and pediatricians alike. This article aims to assist primary care providers in the evaluation of children with bleeding symptoms by reviewing the complexities inherent in diagnosing pediatric bleeding disorders, emphasizing the variability in clinical presentations, testing nuances, and aspects of common bleeding diatheses. The incidence of bleeding disorders among pediatric patients referred for bleeding symptoms and abnormal hemostatic screening remains variable, ranging from 4 % to 11 % across different institutions. A meticulous evaluation-including family history, medication review, and assessment of bleeding severity-is an essential first step in identifying potential bleeding disorders. In patients with a high index of suspicion we recommend screening testing including a complete blood count including blood smear for review, activated partial thromboplastin time (aPTT), prothrombin time (PT), von Willebrand factor (VWF) antigen and activity, and fibrinogen level. Common bleeding disorders in pediatrics include factor deficiencies (including von Willebrand disease) and platelet disorders. A collaborative approach between primary care providers and hematologists is paramount to optimizing outcomes for pediatric patients with bleeding symptoms.</p>\",\"PeriodicalId\":49086,\"journal\":{\"name\":\"Current Problems in Pediatric and Adolescent Health Care\",\"volume\":\" \",\"pages\":\"101762\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Problems in Pediatric and Adolescent Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.cppeds.2025.101762\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Problems in Pediatric and Adolescent Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cppeds.2025.101762","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Bleeding symptoms in children create significant concern for families and pediatricians alike. This article aims to assist primary care providers in the evaluation of children with bleeding symptoms by reviewing the complexities inherent in diagnosing pediatric bleeding disorders, emphasizing the variability in clinical presentations, testing nuances, and aspects of common bleeding diatheses. The incidence of bleeding disorders among pediatric patients referred for bleeding symptoms and abnormal hemostatic screening remains variable, ranging from 4 % to 11 % across different institutions. A meticulous evaluation-including family history, medication review, and assessment of bleeding severity-is an essential first step in identifying potential bleeding disorders. In patients with a high index of suspicion we recommend screening testing including a complete blood count including blood smear for review, activated partial thromboplastin time (aPTT), prothrombin time (PT), von Willebrand factor (VWF) antigen and activity, and fibrinogen level. Common bleeding disorders in pediatrics include factor deficiencies (including von Willebrand disease) and platelet disorders. A collaborative approach between primary care providers and hematologists is paramount to optimizing outcomes for pediatric patients with bleeding symptoms.
期刊介绍:
Recognized for its probing, comprehensive, and evidence-based reviews, Current Problems in Pediatric and Adolescent Health Care devotes each issue to a timely and practical topic in pediatric medicine, presented by leading authorities in the field. The journal offers readers easily accessible information that enhances professional experience and is pertinent to daily pediatric practice. Each issue''s review article is accompanied by an additional special feature designed to highlight a particular aspect of the topic presented.