Department of Hematology/Oncology, Children's Mercy Hospital, Kansas City, MO 64108, USA.
Hematology Am Soc Hematol Educ Program. 2011;2011:170-7. doi: 10.1182/asheducation-2011.1.170.
The coagulopathy of liver disease in pediatric patients presents an unusual set of challenges. Little pediatric data have been published, so this review is based largely on adult studies. There is a precarious balance between deficiencies of clotting factors and anticoagulation factors in liver disease that result in abnormal prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests that would suggest a bleeding tendency, yet the patients can form a clot and are at risk of thromboembolic disease. Attention has centered on thromboelastography and thrombin-generation assays to clarify the patient's ability to control bleeding, but these tests are not routinely available to many treating physicians.
小儿肝病患者的凝血障碍带来了一系列不寻常的挑战。小儿数据发表较少，因此本篇综述主要基于成人研究。肝病中凝血因子和抗凝因子的缺乏存在不稳定的平衡，导致异常的凝血酶原时间（PT）和活化部分凝血活酶时间（aPTT）检测结果，这表明有出血倾向，但患者可以形成血栓，存在血栓栓塞疾病的风险。研究重点集中在血栓弹力描记术和凝血酶生成试验上，以明确患者控制出血的能力，但这些检查对许多治疗医生来说并不常规。
