WordNet

set the speed, duration, or execution of; "we time the process to manufacture our cars very precisely"
a period of time considered as a resource under your control and sufficient to accomplish something; "take time to smell the roses"; "I didnt have time to finish"; "it took more than half my time"
a suitable moment; "it is time to go"
adjust so that a force is applied and an action occurs at the desired time; "The good player times his swing so as to hit the ball squarely"
an indefinite period (usually marked by specific attributes or activities); "he waited a long time"; "the time of year for planting"; "he was a great actor in his time"
regulate or set the time of; "time the clock"
the continuum of experience in which events pass from the future through the present to the past
an instance or single occasion for some event; "this time he succeeded"; "he called four times"; "he could do ten at a clip" (同)clip
a persons experience on a particular occasion; "he had a time holding back the tears"; "they had a good time together"
assign a time for an activity or event; "The candidate carefully timed his appearance at the disaster scene"
shrub with terminal tufts of elongated leaves used locally for thatching and clothing; thick sweet roots are used as food; tropical southeastern Asia, Australia and Hawaii (同)Cordyline terminalis
the syllable naming the seventh (subtonic) note of any musical scale in solmization (同)te, si
the regulation of occurrence, pace, or coordination to achieve a desired effect (as in music, theater, athletics, mechanics)
the time when something happens
the flow of blood from a ruptured blood vessel (同)hemorrhage, haemorrhage
a more or less definite period of time now or previously present; "it was a sign of the times"

PrepTutorEJDIC

〈U〉《冠詞をつけずに》(空間に対しての)『時間』,時 / 〈U〉(時計で示される)『時刻』 / 〈U〉(ある方式で決められる)『時間』,標準時 / 〈C〉〈U〉(特定の)『時』,おり,ころ / 〈U〉《しばしば A ~》(ある長さの)『時間』,期間 / 〈U〉(要する)『時間』;暇 / 《しばしば複数形で》(歴史上の)『時代』 / 《複数形で》時勢,景気 / 《one's ~》(個人の)一生;若いころ;生涯の特定の時期 / 〈U〉《しばしば A ~》(ある経験をした)『時間』 / 〈C〉『…回』,度 / 〈C〉『…倍』 / …の時間を定める / (…に)…の調子を合わせる《+名+to+名》 / …の時間を計る
シ(全音階の第7音)
時間の調節;時間を測定[記録]すること
出血する / 出血;放血
…掛ける

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/11 11:18:17」(JST)

wiki en

Bleeding time is a medical test done on someone to assess their platelets function. It involves making a patient bleed then timing how long it takes for them to stop bleeding.

The term template bleeding time is used when the test is performed to standardized parameters.

Indications

The bleeding time test is a rather old method and indicated when other more reliable and less invasive tests for determining coagulation are not available.^[1] However, it is still to this date the most reliable way of assessing clinical bleeding in patients with uremia.^[2] Historically it was indicated whenever the physician needed information about platelet activation.^[3]

Process

It involves cutting the underside of the subject's forearm, in an area where there is no hair or visible veins. The cut is of a standardized width and depth, and is done quickly by an automatic device.

A blood pressure cuff is used above the wound, to maintain venous pressure at a specified value. The time it takes for the bleeding to stop (i.e. the time it takes for a platelet plug to form) is measured. Cessation of bleeding can be determined by blotting away the blood every several seconds until the site looks 'glassy'.

Ivy method

The Ivy method is the traditional format for this test. While both the Ivy and the Duke method require the use of a sphygmomanometer, or blood pressure cuff, the Ivy method is more invasive than the Duke method, utilizing an incision on the ventral side of the forearm, whereas the Duke method involves puncture with a lancet or special needle. In the Ivy method, the blood pressure cuff is placed on the upper arm and inflated to 40 mmHg. A lancet or scalpel blade is used to make a shallow incision that is 1 millimeter deep on the underside of the forearm.

A standard-sized incision is made around 10 mm long and 1 mm deep. The time from when the incision is made until all bleeding has stopped is measured and is called the bleeding time. Every 30 seconds, filter paper or a paper towel is used to draw off the blood.

The test is finished when bleeding has stopped completely.

A normal value is less than 9 and a half minutes.^[4]

A prolonged bleeding time may be a result from decreased number of thrombocytes or impaired blood vessels. However, it should also be noted that the depth of the puncture or incision may be the source of error.

Normal values fall between 3 – 10 minutes depending on the method used.

Duke Method

With the Duke method, the patient is pricked with a special needle or lancet, preferably on the earlobe^[5] or fingertip, after having been swabbed with alcohol. The prick is about 3–4 mm deep. The patient then wipes the blood every 30 seconds with a filter paper. The test ceases when bleeding ceases. The usual time is about 2–5 minutes.

Interpretation

Bleeding time is affected by platelet function, certain vascular disorders and von Willebrand Disease—not by other coagulation factors such as haemophilia. Diseases that cause prolonged bleeding time include thrombocytopenia, disseminated intravascular coagulation (DIC), Bernard-Soulier disease, and Glanzmann's thrombasthenia.

Aspirin and other cyclooxygenase inhibitors can prolong bleeding time significantly. While warfarin and heparin have their major effects on coagulation factors, an increased bleeding time is sometimes seen with use of these medications as well.

People with von Willebrand disease usually experience increased bleeding time, as von Willebrand factor is a platelet adhesion protein, but this is not considered an effective diagnostic test for this condition.

It is also prolonged in hypofibrinogenemia.^[6]

Laboratory findings in various platelet and coagulation disorders (V - T)
Condition	Prothrombin time	Partial thromboplastin time	Bleeding time	Platelet count
Vitamin K deficiency or warfarin	Prolonged	Normal or mildly prolonged	Unaffected	Unaffected
Disseminated intravascular coagulation	Prolonged	Prolonged	Prolonged	Decreased
Von Willebrand disease	Unaffected	Prolonged or unaffected	Prolonged	Unaffected
Hemophilia	Unaffected	Prolonged	Unaffected	Unaffected
Aspirin	Unaffected	Unaffected	Prolonged	Unaffected
Thrombocytopenia	Unaffected	Unaffected	Prolonged	Decreased
Liver failure, early	Prolonged	Unaffected	Unaffected	Unaffected
Liver failure, end-stage	Prolonged	Prolonged	Prolonged	Decreased
Uremia	Unaffected	Unaffected	Prolonged	Unaffected
Congenital afibrinogenemia	Prolonged	Prolonged	Prolonged	Unaffected
Factor V deficiency	Prolonged	Prolonged	Unaffected	Unaffected
Factor X deficiency as seen in amyloid purpura	Prolonged	Prolonged	Unaffected	Unaffected
Glanzmann's thrombasthenia	Unaffected	Unaffected	Prolonged	Unaffected
Bernard-Soulier syndrome	Unaffected	Unaffected	Prolonged	Decreased or unaffected
Factor XII deficiency	Unaffected	Prolonged	Unaffected	Unaffected
C1INH deficiency	Unaffected	Shortened	Unaffected	Unaffected

The Bleeding Time in Popular Culture

In the 1954 comedy film Doctor in the House, Sir Lancelot Spratt, the intimidating chief of surgery played by James Robertson Justice is asking instructional questions of his medical student. He asks a young student, who has been distracted by a pretty nurse, what 'the bleeding time' is. The student looks at his watch and answers "ten past ten, sir."

References

^ American Society for Clinical Pathology, "Five Things Doctors and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation (American Society for Clinical Pathology), retrieved August 1, 2013 , which cites
1. - Lehman, C. M.; Blaylock, R. C.; Alexander, D. P.; Rodgers, G. M. (2001). "Discontinuation of the bleeding time test without detectable adverse clinical impact". Clinical chemistry 47 (7): 1204–1211. PMID 11427450. edit
  - Peterson, P.; Hayes, T. E.; Arkin, C. F.; Bovill, E. G.; Fairweather, R. B.; Rock Jr, W. A.; Triplett, D. A.; Brandt, J. T. (1998). "The preoperative bleeding time test lacks clinical benefit: College of American Pathologists' and American Society of Clinical Pathologists' position article". Archives of surgery (Chicago, Ill. : 1960) 133 (2): 134–139. doi:10.1001/archsurg.133.2.134. PMID 9484723. edit
  - Lind, S. E. (1991). "The bleeding time does not predict surgical bleeding". Blood 77 (12): 2547–2552. PMID 2043759. edit
^ http://www.slideshare.net/slulabservices/uremic-bleeding
^ Peterson, P.; Hayes, T. E.; Arkin, C. F.; Bovill, E. G.; Fairweather, R. B.; Rock Jr, W. A.; Triplett, D. A.; Brandt, J. T. (1998). "The preoperative bleeding time test lacks clinical benefit: College of American Pathologists' and American Society of Clinical Pathologists' position article". Archives of surgery (Chicago, Ill. : 1960) 133 (2): 134–139. doi:10.1001/archsurg.133.2.134. PMID 9484723. edit
^ "Blood Chemistries". Retrieved 2009-01-02. ^{[dead link]}
^ Schafer, Andrew I.; Loscalzo, Joseph (2003). Thrombosis and hemorrhage. Hagerstwon, MD: Lippincott Williams & Wilkins. p. 397. ISBN 0-7817-3066-X.
^ "Bleeding Time". Retrieved 2009-01-02. ^{[dead link]}

External links

MedlinePlus Medical Encyclopedia

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 出血性素因を有する成人患者へのアプローチ approach to the adult patient with a bleeding diathesis
2. 血小板機能検査 platelet function testing
3. 出血症状を有する小児に対するアプローチ approach to the child with bleeding symptoms
4. Management of bleeding in patients receiving target-specific oral anticoagulants
5. 術前の止血状態評価 preoperative assessment of hemostasis

English Journal

Repair of the donor areas defects after split-thickness skin grafts utilizing an advanced epithelialization dressing.

Fanti PA1, Dika E, Vaccari S, Misciali C, Ismaili A, Barisani A, Patrizi A.
The Journal of dermatological treatment.J Dermatolog Treat.2014 Oct;25(5):434-7. doi: 10.3109/09546634.2012.757286. Epub 2013 Feb 24.
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Ikoma R1, Sakane S2, Niwa K2, Kanetaka S2, Kawano T3, Oridate N4.
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Goto K1, Nakai K1, Shizuta S2, Morimoto T3, Shiomi H1, Natsuaki M1, Yahata M1, Ota C1, Ono K1, Makiyama T1, Nakagawa Y4, Furukawa Y5, Kadota K6, Takatsu Y7, Tamura T8, Takizawa A9, Inada T10, Doi O11, Nohara R12, Matsuda M13, Takeda T14, Kato M15, Shirotani M16, Eizawa H17, Ishii K18, Lee JD19, Takahashi M20, Horie M21, Takahashi M22, Miki S23, Aoyama T24, Suwa S25, Hamasaki S26, Ogawa H27, Mitsudo K6, Nobuyoshi M28, Kita T5, Kimura T1; CREDO-Kyoto Registry Cohort-2 Investigators.
The American journal of cardiology.Am J Cardiol.2014 Jul 1;114(1):70-78. doi: 10.1016/j.amjcard.2014.03.060. Epub 2014 Apr 24.
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Japanese Journal

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後天性血友病A:第VIII因子インヒビター

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NAID 40019541983

Related Pictures

★リンクテーブル★

リンク元	「出血性疾患」「出血時間」
関連記事	「time」「timing」

「出血性疾患」

Bleeding time
	Intervention
MeSH	D001760

　　[★]

英: hemorrhagic disease