It is possible to know whether the patient has abnormal coagulation function before surgery, effectively prevent unexpected situations such as non-stop bleeding during and after surgery, so as to obtain the best surgical effect.
The body's hemostatic function is accomplished by the joint action of platelets, coagulation system, fibrinolytic system and vascular endothelial system. In the past, we used bleeding time as a screening test for hemostatic function defects, but because of its low standardization, poor sensitivity, and inability to reflect the content and activity of coagulation factors, it has been replaced by coagulation function tests. Coagulation function tests mainly include plasma prothrombin time (PT) and PT activity calculated from PT, international normalized ratio (INR), fibrinogen (FIB), activated partial thromboplastin time (APTT) and plasma thrombin time (TT).
PT mainly reflects the function of the extrinsic coagulation system. Prolonged PT is mainly seen in congenital coagulation factor II, V, VII, and X reduction, fibrinogen deficiency, acquired coagulation factor deficiency (DIC, primary hyperfibrinolysis, obstructive jaundice, vitamin K deficiency, and anticoagulant substances in the blood circulation. PT shortening is mainly seen in congenital coagulation factor V increase, early DIC, thrombotic diseases, oral contraceptives, etc.; monitoring PT can be used as the monitoring of clinical oral anticoagulant drugs.
APTT is the most reliable screening test for endogenous coagulation factor deficiency. Prolonged APTT is mainly seen in hemophilia, DIC, liver disease, and massive transfusion of banked blood. Shortened APTT is mainly seen in DIC, prothrombotic state, and thrombotic diseases. APTT can be used as a monitoring indicator for heparin therapy.
TT prolongation is seen in hypofibrinogenemia and dysfibrinogenemia, increased FDP in blood (DIC), and presence of heparin and heparinoid substances in blood (eg, during heparin therapy, SLE, liver disease, etc.).
There was once an emergency patient who received preoperative laboratory tests, and the results of coagulation test were prolonged PT and APTT, and DIC was suspected in the patient. Under the recommendation of the laboratory, the patient underwent a series of DIC tests and the results were positive. No obvious symptoms of DIC. If the patient does not have a coagulation test, and direct surgery, the consequences will be disastrous. Many such problems can be found from the coagulation function test, which has bought more time for the clinical detection and treatment of diseases. Coagulation series testing is an important laboratory test for patients' coagulation function, which can detect abnormal coagulation function in patients before surgery, and should be paid enough attention.
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