Remuzzi G
Laboratory of Kidney Disease, Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
Adv Nephrol Necker Hosp. 1989;18:171-86.
Renal insufficiency is associated with a bleeding tendency. Hemorrhagic manifestations are usually mild (i.e., ecchymoses or purpura) but can be severe in occasional patients who may have gastrointestinal tract or intracranial bleeding. Modern techniques for the management of uremia have definitely reduced the incidence of severe bleeding episodes in patients with renal failure, but hemorrhages still represent a major clinical problem, particularly for patients undergoing surgery or invasive procedures. Although the pathogenesis of uremic bleeding has not been completely elucidated, in the past 10 years a number of studies have contributed substantially to our knowledge of the cause of uremic bleeding tendency and have indicated new therapeutic strategies. The present review will focus mainly on modern concepts of the cause of uremic bleeding and will critically analyze the various therapeutic approaches.
肾功能不全与出血倾向相关。出血表现通常较轻（如瘀斑或紫癜），但在少数可能发生胃肠道或颅内出血的患者中可能较为严重。现代尿毒症管理技术确实降低了肾衰竭患者严重出血事件的发生率，但出血仍然是一个主要的临床问题，尤其是对于接受手术或侵入性操作的患者。尽管尿毒症出血的发病机制尚未完全阐明，但在过去10年中，一些研究对我们了解尿毒症出血倾向的原因做出了重大贡献，并指出了新的治疗策略。本综述将主要关注尿毒症出血原因的现代概念，并对各种治疗方法进行批判性分析。
