重症监护病房肝病患者的血栓预防与出血控制  

Thromboprophylaxis and bleeding control in patients with liver disease in the intensive care unit

作　　者：邢文立[1] 李谦[1] XING Wenli, LI Qian(Intensive Care Unit, Tianfin Second People＇s Hospital ＆ Tianfin Institute of Hepatology, Tianjin 300192, China)

机构地区：[1]天津市第二人民医院ICU、天津市肝病医学研究所,天津300192

出　　处：《临床肝胆病杂志》2018年第10期2237-2240,共4页Journal of Clinical Hepatology

摘　　要：肝脏涉及多种与凝血相关的蛋白合成,常常伴有复杂的凝血系统异常。实验室及临床证据提示肝病患者会达到一个凝血再平衡的状态,但是这种平衡状态相对脆弱,所以临床上出血及血栓形成事件常有发生。急、慢性肝病患者都可能因为出血或血栓形成等各种严重的并发症而进入重症监护病房。胃肠道出血、全身或局部血栓形成和体外循环中发生的凝血事件等是重症监护病房中肝病患者常见的并发症。给予肝病患者个体化的预防血栓形成的治疗,并给予限制性的输血策略(等待观察策略)是合理的。Liver diseases are associated with complex abnormalities in the coagulation system as the liver is involved in the synthesis of various coagulation-related proteins. Laboratory and clinical evidence suggests that patients with liver disease may achieve a state of rebalanced hemostasis,but such balance is relatively unstable,and thus bleeding and thrombosis events are observed in clinical practice. Patients with acute or chronic liver diseases might be admitted to the intensive care unit（ ICU） due to serious complications such as bleeding and thrombosis. Gastrointestinal bleeding,systemic or local thrombosis,and coagulation events in extracorporeal circulation are common complications observed in patients with liver disease in the ICU. An individualized management plan of thromboprophylaxis and a wait-and-see policy for limited blood transfusion are reasonable for patients with liver disease.

关 键 词：肝疾病 止血障碍 输血 血栓形成 综述 

分 类 号：R575.2[医药卫生—消化系统]