肝硬化止血再平衡的机制及输血、抗凝时机的选择

Mechanism of rebalanced hemostasis in liver cirrhosis and the timing of blood transfusion and anticoagulation

肝硬化患者体内存在重建的止血再平衡,但此平衡状态不稳定,可轻易的被应激因素打破,导致出血或血栓形成。由于肝硬化止血再平衡复杂的发病机制,目前有限的监测和检查方法,以及临床医生的认识不足等原因,导致临床上缺乏预防和解决平衡状态被打破的有效策略。结合近年来的文献,本文总结了肝硬化止血再平衡的发生机制以及出血、血栓形成的原因,并讨论了输血与止血再平衡的关系以及血栓形成时抗凝药物的选择,为临床相关问题的解决提供了理论依据和新的思路。

Reconstructed rebalanced hemostasis exists in patients with liver cirrhosis,while such balance is unstable and can be easily broken by stress factors,which may lead to bleeding or thrombosis.There is a lack of effective strategies to prevent and solve the disrupted balance in clinic due to the complex pathogenesis of rebalanced hemostasis,limited testing methods,and insufficient awareness among clinicians.With reference to the articles in recent years,this article summarizes the mechanism of rebalanced hemostasis in liver cirrhosis and the causes of bleeding and thrombosis and discuss the association between blood transfusion and rebalanced hemostasis and the selection of anticoagulant drugs during thrombosis,in order to provide a theoretical basis and new ideas for solving related issues in clinical practice.