摘要
慢性肝病患者的凝血功能障碍是一个复杂的动态过程,涉及血小板异常、凝血因子合成减少、抗凝系统削弱及纤溶功能紊乱。这些改变打破了原有的凝血平衡,导致患者同时面临出血与血栓形成的双重风险。本综述系统阐述了慢性肝病中凝血系统“再平衡”的机制,并总结了当前的临床管理策略。在治疗上,需个体化权衡出血与血栓风险,出血的防治包括预防性血制品输注、维生素K及血小板生成素受体激动剂等的应用;而血栓的防治则需密切监测凝血指标谨慎选择抗凝药物。目前,该领域仍缺乏统一的治疗指南,未来需更多研究以优化个体化治疗方案,改善患者预后。
Coagulopathy in patients with chronic liver diseases is a complex dynamic process,involving abnormal platelets,reduced synthesis of coagulation factors,weakened anticoagulation system and fibrinolytic dysfunction.These changes disrupt the original coagulation balance,exposing patients to the dual risks of bleeding and thrombosis simultaneously.This review systematically expounds the mechanism of"rebalancing"of the coagulation system in chronic liver diseases and summarizes the current clinical management strategies.In terms of treatment,it is necessary to balance the risks of bleeding and thrombosis on an individualized basis.The prevention and treatment of bleeding include preventive blood product infusion,the application of vitamin K and thrombopoietin receptor agonists,etc.The prevention and treatment of thrombosis require close monitoring of coagulation indicators and careful selection of anticoagulant drugs.At present,there is still a lack of unified treatment guidelines in this field.More research is needed in the future to optimize individualized treatment plans and improve patient prognosis.
作者
陈晓茂
陈旭
CHEN Xiaomao;CHEN Xu(Department of Interventional Radiography,Guangzhou First People's Hospital,Guangzhou 510180,China;不详)
出处
《中国医学创新》
2025年第36期166-171,共6页
Medical Innovation of China
关键词
慢性肝病
凝血功能障碍
出血
血栓形成
治疗策略
Chronic liver diseases
Coagulopathy
Bleeding
Thrombosis
Treatment strategies
