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标题: 新的AASLD指南要求我们重新考虑我们如何看待肝硬化出血风险 [打印本页]

作者: StephenW    时间: 2021-3-5 18:59     标题: 新的AASLD指南要求我们重新考虑我们如何看待肝硬化出血风险

New AASLD Guidelines Ask Us to Reconsider How We View Bleeding Risk in Cirrhosis

David A. Johnson, MD
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March 04, 2021

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This transcript has been edited for clarity.

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia.

Kudos to the American Association for the Study of Liver Diseases (AASLD) for their latest expert consensus document. Among the several topics covered in these 48-page guidelines are vascular anomalies such as portal vein and hepatic vein thrombosis, and hepatic and splenic aneurysms. However, today I wanted to highlight for you the section dealing with coagulation management in patients with cirrhosis, including how it relates to interventions we commonly deal with as gastroenterologists, such as endoscopic or surgical procedures.
Reconsidering Cirrhosis-Related Bleeding

It would be an understatement to say that patients with cirrhosis have multiple alterations in their hemostatic system. It needs to be better understood, however, that there are hemostatic changes promoting both bleeding and clotting that occur simultaneously in any given individual patient. These changes may in fact counteract each other.
作者: StephenW    时间: 2021-3-5 19:00

新的AASLD指南要求我们重新考虑我们如何看待肝硬化出血风险

戴维·约翰逊(David A. Johnson),医学博士
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2021年3月4日

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09:49

为了清楚起见,此成绩单已经过编辑。

你好。我是位于弗吉尼亚州诺福克的东弗吉尼亚医学院的医学教授兼胃肠病学主任戴维·约翰逊(David Johnson)博士。

感谢美国肝病研究协会(AASLD)的最新专家共识文件。在这些48页的指南中涉及的几个主题中,包括血管异常,例如门静脉和肝静脉血栓形成,以及肝和脾动脉瘤。但是,今天,我想为您重点介绍肝硬化患者的凝血管理部分,包括与我们通常作为胃肠病医生处理的干预措施(例如内窥镜或外科手术)的关系。
重新考虑肝硬化相关的出血

可以说肝硬化患者的止血系统有多种变化,这是一种轻描淡写的说法。但是,需要更好地理解,在任何给定的个体患者中,都有止血变化同时促进出血和凝血。这些变化实际上可能相互抵消。
作者: StephenW    时间: 2021-3-5 19:00

https://www.medscape.com/viewarticle/946425#vp_1




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