Gazzard B G, Clark R, Borirakchanyavat V, Williams R
Gut. 1974 Feb;15(2):89-93. doi: 10.1136/gut.15.2.89.
Treatment of the coagulation disturbances developing with hepatic damage following a paracetamol overdose was assessed in a controlled trial of 22 patients, one half being given heparin and fresh frozen plasma and the other fresh frozen plasma alone. No significant difference was observed either in the speed of correction of the coagulation defect or in the clinical outcome. Two-thirds of the patients had evidence of disseminated intravascular coagulation, but despite the presence of a severe coagulation defect, significant bleeding occurred in only five patients. This may be because with paracetamol-induced hepatic necrosis both the coagulation defect (and possibly other features attributable to severe hepatic insufficiency) are of shorter duration than in hepatic necrosis due to causes such as viral hepatitis in which the liver damage may be a continuing process.
在一项针对22名患者的对照试验中，评估了对乙酰氨基酚过量导致肝损伤后出现的凝血紊乱的治疗方法。其中一半患者给予肝素和新鲜冰冻血浆，另一半仅给予新鲜冰冻血浆。在凝血缺陷的纠正速度或临床结果方面均未观察到显著差异。三分之二的患者有弥散性血管内凝血的证据，但尽管存在严重的凝血缺陷，仅有5名患者发生了明显出血。这可能是因为对乙酰氨基酚引起的肝坏死中，凝血缺陷（以及可能归因于严重肝功能不全的其他特征）的持续时间比病毒性肝炎等原因导致的肝坏死短，在病毒性肝炎中，肝损伤可能是一个持续的过程。
