关于订购手术前凝血试验的共识文件
J L Jover Pinillos1, R Ferrandis Comes2, J V Llau Pitarch3
1Servicio de Anestesiología y Reanimación, Hospital Verge dels Lliris, Alcoy, Alicante, Spain.
Revista espanola de anestesiologia y reanimacion
|September 25, 2025
概括
常规的手术前凝血测试往往对出血问题不敏感. 新的共识建议强调病史,风险因素和手术类型,而不是通用测试,以改善患者护理.
科学领域:
- 麻醉学 麻醉学
- 血液学 血液学 血液学
- 临床病理学 临床病理学
背景情况:
- 标准的手术前凝血测试经常无法检测出特定的静血异常.
- 尽管在许多地区缺乏明确的临床指导,但这些不敏感的测试的例行订单仍然存在.
研究的目的:
- 为西班牙进行手术前凝血试验的适当排序制定基于共识的建议.
- 解决关于使用常规凝血查的明确指导的缺口.
主要方法:
- 一个3轮的,在线,多中心的德尔菲研究,涉及50名专家麻醉师.
- 专家小组成员在1-9的利克尔特尺度上对46个陈述进行了评分,共识被定义为≥70%的评分≥7.
主要成果:
- 29个声明被接受并综合成6个类别的21个建议.
- 关键发现包括避免普遍测试,根据患者病史和风险因素做出决定,并使用直接口服抗凝剂患者的特定测试.
结论:
- 术前凝血检测应保留给已知出血障碍患者或接受高出血风险手术的患者.
- 建议旨在优化凝血测试的使用,提高诊断准确性和患者安全.
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