止血功能筛查方法的局限性与改善

Limitation of haemostasis screening tests and improvement

现行的止血功能筛查试验在提示患者的出血倾向中有重要作用。充分认识其局限性可为正确解释临床应用中出现的一些不足提供依据，也可促进止血功能筛查方法的改善。改善的关键是充分的病史、家族史调查，细致的临床体检，发现出血表现并结合出血筛查试验。探索能从总体上反映止血功能缺陷的试验也是改善的途径，如血栓弹力图、标定的血栓形成图和总体血小板功能分析法等，但其临床适用性尚需更多的研究来证实。目前，现行的止血功能筛查试验尚无法替代。

The haemostasis screening tests play an important role in indicating the risk of patient＇s bleeding. Fully recognizing the limitations of these tests can explain some shortages occurred in the clinical usage and improve the methods for haemostasis screening. The key points for improving is to investigate the history and family history of patients and find the signs of bleeding. Some tests for screening the global defects of haemostasis can also be used for improvement, e. g the thromboelastography, the calibrated automated thrombogram and global analysis of plataletes function, but more clinical researches are needed to identify their effects. So, the tests used now can still not be replaced.