常规凝血检查预测肝硬化出血的临床价值

摘要

早期评估肝硬化出血具有重要的临床意义.常规凝血检查是一项操作简单、价格便宜的实验室检查方法,已被广泛用于临床评估肝硬化患者的凝血功能.但近年来许多相关研究发现肝硬化患者不仅存在出血倾向,还可能存在血栓倾向.也有研究表明常规凝血检查不能准确评估肝硬化患者整体的凝血状态.目前,应用常规凝血检查评估肝硬化出血的传统观点受到巨大挑战.本文从肝硬化患者促凝与抗凝功能异常、上消化道出血潜在机制以及常规凝血检查与出血间的关系等方面进行综述.%Early prediction of bleeding in liver cirrhosis is very important.Conventional coagulation tests are cheap and convenient,which are widely used to evaluate the coagulation function in liver cirrhosis.However,except for bleeding tendency,recent evidence also suggested thrombotic tendency in liver cirrhosis.Additionally,some studies demonstrated that conventional coagulation tests might not accurately reflect the general status of coagulation and anticoagulation.The role of conventional coagulation tests in assessing the bleeding in liver cirrhosis has been greatly challenged.This paper aims to review the coagulation and anticoagulation abnormalities,the mechanisms of upper gastrointestinal bleeding and the association between conventional coagulation tests and bleeding in patients with liver cirrhosis.