血栓弹力图在肝硬化及加速性血管内凝血和纤维蛋白溶解（AICF）管理中的应用。
Use of thromboelastography in the management of liver cirrhosis and accelerated intravascular coagulation and fibrinolysis (AICF).
作者信息
Peterson Thomas Joseph, Webb Allison Margaret Brown, Vipler Benjamin Samuel
机构信息
Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, Maryland, USA.
Department of Internal Medicine-Psychiatry, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
出版信息
BMJ Case Rep. 2016 Dec 14;2016:bcr2016218294. doi: 10.1136/bcr-2016-218294.
In the presented case, the authors describe an obese middle-aged man that presented to the emergency department for persistent oedema, scleral icterus and fatigue. He was admitted to the hospital and diagnosed with liver cirrhosis via transjugular liver biopsy. He continued to bleed from the biopsy site for 5 days from accelerated intravascular coagulation and fibrinolysis (AICF) requiring multiple transfusions of packed red blood cells, fresh-frozen plasma and cryoprecipitate. The authors then used thromboelastography (TEG) to further characterise the patient's coagulopathy, which revealed platelet inhibition. The results of the TEG significantly changed future transfusion management. Finally, the authors conducted a literature review to summarise the current literature available for the use of TEG in the management of liver cirrhosis with AICF.
在本病例中，作者描述了一名肥胖的中年男性，他因持续性水肿、巩膜黄疸和疲劳就诊于急诊科。他被收治入院，并通过经颈静脉肝活检诊断为肝硬化。由于加速血管内凝血和纤维蛋白溶解（AICF），他的活检部位持续出血5天，需要多次输注浓缩红细胞、新鲜冰冻血浆和冷沉淀。作者随后使用血栓弹力图（TEG）进一步评估患者的凝血病，结果显示血小板抑制。TEG的结果显著改变了未来的输血管理。最后，作者进行了文献综述，以总结目前关于TEG在AICF肝硬化管理中应用的现有文献。
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