Ko te ngoikore o te toto toto he wāhanga o te mate ate, ā, he mea nui hoki i roto i te nuinga o ngā kaute matapae. Ko ngā panonitanga o te taurite o te hemostasis ka arahi ki te toto, ā, ko ngā raruraru toto toto he raruraru haumanu nui tonu. Ka taea te wehewehe i ngā take o te toto toto ki (1) te toto toto tiketike, kāore he pānga ki te tikanga hemostatic; (2) te toto toto i roto i te mucosal, i te patunga wero rānei, he maha ngā wā ka memeha wawe te thrombus, ka nui rānei te fibrinolysis, e kiia nei ko te accelerated intravascular coagulation me te fibrinolysis i roto i te mate ate Melt (AICF). Kāore i te mārama te tikanga o te hyperfibrinolysis, engari kei roto ko ngā panonitanga o te coagulation intravascular me te fibrinolysis. Ka kitea te coagulation rerekē i roto i te portal vein thrombosis (PVT) me te mesenteric vein thrombosis, me te deep vein thrombosis (DVT). He maha ngā wā e hiahiatia ana he maimoatanga anticoagulation, he ārai rānei mō ēnei āhuatanga haumanu. Ko te microthrombosis i roto i te ate i puta mai i te hypercoagulability ka puta te ngoikore o te ate.
Kua whakamāramahia ētahi huringa matua o te ara hemostasis, ko ētahi ka totohu, ko ētahi ka totohu (Pikitia 1). I roto i te cirrhosis ate pumau, ka taurite anō te pūnaha nā ngā āhuatanga koretake, engari he kore pumau tēnei taurite, ā, ka pāngia nuitia e ētahi atu āhuatanga, pērā i te āhua o te rōrahi toto, te mate pūnaha, me te mahi a te whatukuhu. Ko te thrombocytopenia pea te huringa pathological tino noa nā te hypersplenism me te hekenga o te thrombopoietin (TPO). Kua whakaahuahia hoki te ngoikore o te pereti toto, engari i tino whakakorengia ēnei huringa anticoagulant e te pikinga o te endothelial-derived von Willebrand factor (vWF). Waihoki, ko te hekenga o ngā āhuatanga procoagulant i ahu mai i te ate, pērā i ngā āhuatanga V, VII, me te X, ka hua ake he wā prothrombin roa, engari ka tino whakakorengia tēnei e te hekenga o ngā āhuatanga anticoagulant i ahu mai i te ate (ina koa ko te pūmua C). Hei tāpiri, ko te pikinga o te endothelial-derived factor VIII me te iti o te pūmua C ka hua ake he āhua hypercoagulable. Ko ēnei huringa, me te noho pūmau o ngā uaua me te kino o te endothelial (te triad a Virchow), i arahi ki te haere tahi o te PVT me te DVT i ētahi wā i roto i ngā tūroro e pangia ana e te cirrhosis ate. I roto i te poto, ko ngā ara hemostatic o te cirrhosis ate ka tauritehia i roto i te āhua kore pumau, ā, ka taea te whakapiko i te haere tonu o te mate ki tetahi taha.
Tohutoro：O'Leary JG, Greenberg CS, Patton HM, Caldwell SH.AGA Whakahōu Mahi Hauora: Te Pupuhi i roto i te Cirrhosis.Gastroenterology.2019,157(1):34-43.e1.doi:10.1053/j.gastro.2019.03.070.
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