肝硬化患者的出血机制  

Mechanism of bleeding in patients with liver cirrhosis

作　　者：刘鹏亮[1] 王炳元[1] 

机构地区：[1]中国医科大学附属第一医院消化内科,辽宁沈阳110001

出　　处：《胃肠病学和肝病学杂志》2009年第2期170-173,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：肝硬化患者最常见的并发症是消化道出血,也是导致患者急性死亡的最重要原因之一。肝硬化消化道出血的机制包括止血功能异常、凝血功能异常、纤溶功能异常、血管因素和血小板减少等。食管、胃底静脉曲张破裂出血是危及肝硬化患者生命最主要的并发症,死亡率极高。随着门静脉压力的升高,内脏血管可发生明显的病理改变,称为门静脉高压性血管病变,可引起便血、大便隐血或消化道大出血。多种凝血因子、天然抗凝剂、纤溶蛋白复合物等都在肝脏产生,慢性肝病时,可出现凝血机制障碍。组织因子和Ⅻ因子是参与止血的重要因子,肝硬化时,两者发生障碍。近年来,肝硬化患者血小板减少症越来越受到关注。Alimentary tract hemorrhage is the most common complication in liver cirrhosis patients, which is also the most important cause of acute death. The mechanism includes coagulation disorder, disorder of hemostasis, fibrinolysis system disorder, or thrombocytopenia etc. Variceal bleeding of esophagus and ventriculi veins is the most main complication of liver cirrhosis patient, which has extremely high mortality rate. With the portal pressure ascension, the internal vessels may have the obvious pathology change, which is called the portal vein high piezotropy angiopathy. This pathology change may cause hemafecia, stool occult blood, and massive hemorrhage of gastrointestinal tract. Because many kinds of hemoglutination factors such as the natural anticoagulants, the filament dissolve the protein compounds and so on are all the products of live, disturbances of blood coagulation may appear when chronic disease of the liver occur. The tissue factor and Ⅻ factor are the important factor which participate the hematischesis process. In recent years, thromboeytopenia in liver cirrhosis patients receives more and more attention.

关 键 词：肝硬化 凝血障碍 止血障碍 纤溶系统障碍 

分 类 号：R575.2[医药卫生—消化系统]