Ua wehewehe ʻia kekahi mau hoʻololi koʻikoʻi o ke ala hemostasis, maʻa koko kekahi a maʻa nā mea ʻē aʻe (Figure 1).I ka stable ate cirrhosis, e hoʻoponopono hou ʻia ka ʻōnaehana ma muli o nā kumu dysregulated, akā ʻaʻole paʻa kēia koena a e hoʻopilikia nui ʻia e nā kumu ʻē aʻe, e like me ke kūlana o ke koko, ka maʻi ʻōnaehana, a me ka hana ʻana.ʻO Thrombocytopenia paha ka loli maʻamau maʻamau ma muli o ka hypersplenism a me ka emi ʻana o ka thrombopoietin (TPO).Ua wehewehe pū ʻia ka hana ʻino o ka platelet, akā ua hoʻololi nui ʻia kēia mau hoʻololi anticoagulant e ka piʻi ʻana o ka endothelial-derived von Willebrand factor (vWF).Pēlā nō, ʻo ka emi ʻana o nā kumu procoagulant i loaʻa i ka ate, e like me nā mea V, VII, a me X, alakaʻi i ka manawa prothrombin lōʻihi, akā ua hoʻopiʻi nui ʻia kēia e ka emi ʻana o nā kumu anticoagulant i loaʻa i ka ate (ʻoi aku ka protein C).Eia kekahi, ke kiʻekiʻe o ka endothelial-derived factor VIII a me ka protein haʻahaʻa C alakaʻi i kahi kūlana hypercoagulable.ʻO kēia mau hoʻololi, i hui pū ʻia me nā stasis venous pili a me ka pōʻino endothelial (Virchow's triad), alakaʻi i ka synergistic progression o PVT a me DVT i kekahi manawa i nā maʻi me ka cirrhosis ate.I ka pōkole, hoʻoponopono pinepine ʻia nā ala hemostatic o ka cirrhosis ate ma kahi ʻano paʻa ʻole, a hiki ke hili ʻia ka piʻi ʻana o ka maʻi ma kekahi ʻaoʻao.

Hōʻike: O'Leary JG, Greenberg CS, Patton HM, Caldwell SH.AGA Hoʻomaʻamaʻa Kauka Hana Hou: Coagulation inCirrhosis.Gastroenterology.2019,157(1):34-43.e1.doi:10.1053/j.gastro.2019.03.070 .