肝移植术后早期血栓风险及预防性抗凝研究进展  

Early thrombotic risks and prophylactic anticoagulation after liver transplantation

作　　者：杨泓钊 梁秋实 杨俭[1] 吕涛[1] 谢坤林 周静[3] 杨家印[1] 吴泓[1] Yang Hongzhao;Liang Qiushi;Yang Jian;Lyu Tao;Xie Kunlin;Zhou Jing;Yang Jiayin;Wu Hong(Liver Transplantation Center,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院肝移植中心,成都610041 [2]四川大学华西医院血液内科,成都610041 [3]四川大学华西医院临床检验科,成都610041

出　　处：《中华器官移植杂志》2023年第1期53-61,共9页Chinese Journal of Organ Transplantation

摘　　要：在肝移植术后早期,受者的凝血功能处于脆弱的平衡之中。受到各种复杂机制的影响,血液通常会倾向于高凝状态。诸如凝血因子与生理性抗凝物质失衡、血管性血友病因子水平升高、纤溶抑制发生以及使用免疫抑制剂等内在或外在因素,都会导致肝移植术后早期血液高凝状态形成。血液高凝状态可能导致肝动脉血栓形成、门静脉血栓形成及深静脉血栓形成等血栓并发症。术后采用药物预防性抗凝,在降低术后早期血栓风险方面有一定效果,但尚缺乏高质量证据。本文重点阐述目前关于肝移植术后早期凝血功能紊乱、血栓事件发生及预防性抗凝中的最新研究进展。In early stage after liver transplantation(LT),coagulation function of recipients stays in a fragile balance.Affected by a variety of complex mechanisms,blood is usually hypercoagulable.An imbalance between coagulation factors and physiological anticoagulants,elevated level of vWF,an occurrence of fibrinolysis inhibition and dosing of immunosuppressive agents cause a hypercoagulable state in an early stage after LT.Blood hypercoagulability may lead to such thrombotic complications as hepatic artery,portal vein and deep vein thromboses.Some studies have demonstrated that postoperative prophylactic anticoagulation has some effect in reducing the risks of early postoperative thrombosis.However,there is still a great lack of high-quality evidence.This review summarized the latest researches on early coagulation dysfunction,thrombosis and preventive anticoagulation after LT.

关 键 词：肝移植 高凝状态 血栓 抗凝治疗 

分 类 号：R657.3[医药卫生—外科学]