出血性疾病的诊断思维

Dagnostic thinking of hemorrhagic disorders

出血性疾病是以自发性出血或轻度外伤后过度出血为特征的一组疾病,包括血管因素、血小板、凝血以及纤溶等异常。对于出血性疾病的诊断,除了依赖病史和临床出血特征外,实验室检查至关重要。其实验室检查分为初筛试验和确诊试验。初筛试验包括血小板计数(PLT)、凝血酶原时间(PT)和活化的部分凝血活酶时间(APTT),根据PLT、PT和APTT初筛结果,对出血性疾病进行分类诊断和初步诊断,然后在此基础上再进行相应的确诊试验,最后完成对出血性疾病的明确诊断。

Hemorrhagic disorders encompass various diseases characterized by spontaneous bleeding or excessive bleeding after minor trauma.The etiologies of hemorrhagic disorders include vascular,platelet,coagulation and fibrinolysis system abnormalities.Concerning the diagnosis of hemorrhagic disorders,it is vital to take laboratory tests besides depending on medical history and clinical bleeding traits.Laboratory tests of hemorrhagic disorders fall into screening test and confirmatory test.Screening tests contain platelets count（PLT）,prothrombin time（PT）,activated partial thromboplastin time（APTT）.On the results of PLT,PT and APTT,diagnosis and initial diagnosis were screened for hemorrhagic disorders.At last,some related confirmatory tests were required to clarify the hemorrhagic disorders.