中国实用外科杂志2026，Vol.46Issue(5)：682-685,696,5.DOI:10.19538/j.cjps.issn1005-2208.2026.05.15
肝脏相关出凝血功能障碍的机制与处理研究进展
Advances in the mechanisms and management of liver-re-lated coagulation and hemostatic disorders
摘要
Abstract
Liver-related coagulation dysfunction is commonly observed in liver cirrhosis,hepatocellular carcinoma,sepsis-associated liver injury,and post-hepatectomy states.The underlying pathology is a remodeling and dysregulation of the dynamic equilibrium among procoagulant,anticoagulant,and fibrinolytic systems,often manifesting as coexisting bleeding and thrombosis.The traditional coagulation cascade model and routine coagulation tests primarily focus on changes in coagulation factor levels,which fail to fully capture the multicellular synergistic regulation and dynamic hemostatic status within the hepatic microenvironment.Recent advances in the cell-based coagulation model,immunothrombosis theory,and hepatic sinusoidal biology multicellular interaction research have revealed that liver hemostasis regulation is a dynamic network involving hepatocytes,liver sinusoidal endothelial cells,Kupffer cells and inflammatory signals.Under physiological conditions,liver is responsible for the synthesis,supply,and clearance of coagulation factors.Under pathological conditions,this network undergoes remodeling,characterized by disrupted hepatic sinusoidal multicellular interactions and an imbalance in coagulation factor synthesis-clearance homeostasis.Further perspectives should reconceptualize liver hemostatic regulation from a multicellular network and dynamic systems viewpoint,integrating molecular biology techniques with dynamic functional monitoring to establish more precise assessment and intervention strategies.关键词
肝疾病/出凝血调控/肝脏微环境/再平衡止血/临床管理Key words
liver diseases/coagulation and hemostatic regulation/hepatic microenvironment/rebalanced hemostasis/clinical management分类
医药卫生引用本文复制引用
张靖垚,番敏,曹茜蓉,张兴,任航雨,冷昊泽,刘昌..肝脏相关出凝血功能障碍的机制与处理研究进展[J].中国实用外科杂志,2026,46(5):682-685,696,5.基金项目
四大慢病重大专项(No.2025ZD0551500) （No.2025ZD0551500）
国家自然科学基金项目(No.82472191) Noncommunicable Chronic Diseases-National Science and Technology Major Project(No.2025ZD0551500) （No.82472191）
National Natural Science Foundation of China(No.82472191) （No.82472191）
