重症监护病房收治的晚期肝病患者止血紊乱的处理。
Management of Hemostatic Disorders in Patients With Advanced Liver Disease Admitted to an Intensive Care Unit.
机构信息
Surgical Research Laboratory and Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, GZ, the Netherlands.
Liver Intensive Therapy Unit, Institute of Liver Studies, Kings College Hospital, London, United Kingdom.
出版信息
Transfus Med Rev. 2017 Oct;31(4):245-251. doi: 10.1016/j.tmrv.2017.06.002. Epub 2017 Jun 23.
Patients with liver diseases frequently acquire complex changes in their hemostatic system. Traditionally, bleeding complications in patients with liver disease were ascribed to these hemostatic changes, and liver diseases were considered as an acquired bleeding disorder. Nowadays, it is increasingly acknowledged that patients with liver diseases are in "hemostatic rebalance" due to a commensurate decline in pro- and anticoagulant drivers. Indeed, both thrombosis and bleeding may complicate liver disease. Such complications may be particularly worrisome in critically ill patients with liver disease. This review will outline knowns and unknowns in prediction, prevention, and treatment of bleeding and thrombosis in patients with liver disease admitted to an intensive care unit.
患有肝脏疾病的患者经常会出现其止血系统的复杂变化。传统上，归因于这些止血变化导致了肝病患者的出血并发症，并且将肝脏疾病视为获得性出血性疾病。如今，越来越多的人认识到，由于促凝和抗凝因子的相应下降，患有肝脏疾病的患者处于“止血再平衡”状态。实际上，血栓形成和出血都可能使肝病复杂化。在患有肝脏疾病的重症患者中，这些并发症可能特别令人担忧。这篇综述将概述在重症监护病房收治的肝病患者中，对出血和血栓形成的预测、预防和治疗方面的已知和未知情况。
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