Corrigan J J
Contemp Anesth Pract. 1981;4:1-11.
Although the coagulopathies encountered in patients with liver disease can be multifactorial, the most common cause is underproduction of certain coagulation factors synthesized by the liver. Generally, vitamin K and replacement therapy are all that is necessary. In the rare instance in which the coagulopathy may be complicated by hyperfibrinolysis or disseminated intravascular coagulation, replacement therapy may not suffice and other means of correcting the defect may be necessary. The prothrombin time, partial thromboplastin time, platelet count, fibrinogen concentration, and a test for fibrinolysis are recommended as the initial workup for the bleeding patient with underlying liver disease. Other, more specific tests may be necessary to differentiate the various causes of the defects in the hemostatic mechanism in these patients.
虽然肝病患者出现的凝血功能障碍可能是多因素的，但最常见的原因是肝脏合成的某些凝血因子产生不足。一般来说，维生素K和替代疗法就足够了。在罕见的情况下，凝血功能障碍可能并发高纤维蛋白溶解或弥散性血管内凝血，替代疗法可能不够，可能需要其他纠正缺陷的方法。对于有潜在肝病的出血患者，推荐进行凝血酶原时间、部分凝血活酶时间、血小板计数、纤维蛋白原浓度和纤维蛋白溶解试验作为初步检查。可能需要其他更具体的检查来区分这些患者止血机制缺陷的各种原因。
