Blasi Annabel
Annabel Blasi, Anesthesia Department, Hospital Clínic, Institut d´investigacions Biomediques Agustí Pi i Sunyer, 08037 Barcelona, Spain.
World J Gastroenterol. 2015 Sep 21;21(35):10062-71. doi: 10.3748/wjg.v21.i35.10062.
There is a discrepancy between the information from clotting tests which have routinely been used in clinical practice and evidence regarding thrombotic and bleeding events in patients with liver disease. This discrepancy leads us to rely on other variables which have been shown to be involved in haemostasis in these patients and/or to extrapolate the behaviour of these patients to other settings in order to decide the best clinical approach. The aims of the present review are as follows: (1) to present the information provided by clotting tests in cirrhotic patients; (2) to present the factors that may influence clotting in these patients; (3) to review the clinical evidence; and (4) to put forward a clinical approach based on the first 3 points.
临床实践中常规使用的凝血检测所提供的信息与肝病患者血栓形成和出血事件的证据之间存在差异。这种差异导致我们依赖于其他已被证明与这些患者止血有关的变量,和/或将这些患者的情况外推至其他情形,以便确定最佳的临床治疗方法。本综述的目的如下:(1) 介绍肝硬化患者凝血检测所提供的信息;(2) 介绍可能影响这些患者凝血的因素;(3) 回顾临床证据;(4) 根据前三点提出一种临床治疗方法。