Dig Liver Dis. 2016 May;48(5):455-467. doi: 10.1016/j.dld.2016.02.008. Epub 2016 Feb 27.
Patients with cirrhosis present with hemostatic alterations secondary to reduced availability of pro-coagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.
肝硬化患者会出现由于促凝血因子和抗凝血因子可用性降低而继发的止血改变。这些变化的净效应是止血系统重新达到平衡。意大利肝脏研究协会（AISF）和意大利内科医学协会（SIMI）推动了一场关于肝硬化患者止血平衡的共识会议。共识过程始于专家科学委员会对文献的回顾，并于2014年12月在罗马举行的正式共识会议上结束。这些声明根据证据质量和推荐强度进行分级，并由一个独立评审团批准。此处呈现的声明突出了当前实验室检测在评估肝硬化患者出血和血栓形成风险方面的优缺点、这种情况下止血紊乱的病理生理学，并概述了肝硬化患者出血和血栓形成的最佳管理方法。
