摘要
门静脉系统血栓是门静脉系统发生的血栓性病变,多种病因可导致门静脉系统血栓,因其发生部位、范围、堵塞血管程度及形成时间长短不同,临床表现各异,部分严重血栓可导致胃肠道淤血坏死、肝功能不全、食管胃底曲张静脉破裂出血、门静脉高压性胆道病,更甚者可危及生命。多普勒超声及腹部增强CT/MRI检查是诊断门静脉系统血栓的重要辅助检查方式,对于该疾病的早期诊疗、严重程度评估及指导针对性的治疗有重要意义。门静脉系统血栓因其严重程度不同,治疗方式方法各异,主要是针对门静脉系统血栓本身及其引起的并发症。对于存在肠道淤血坏死、部分门静脉高压症合并食管胃底曲张静脉破裂出血、脾肿大、脾功能亢进、门静脉高压性胆道病及终末期肝病患者须行外科手术治疗。综述了门静脉系统血栓的病因、临床表现、诊断及外科治疗进展。
Portal vein thrombosis refers to thrombotic lesions in the portal vein and is caused by various etiologies. Its clinical manifestations vary with location,extension,degree of vascular occlusion,and formation time,and severe thrombosis may cause gastrointestinal congestion and necrosis,liver insufficiency,esophagogastric variceal bleeding,and portal hypertensive biliary disease and even threatens patients＇ life.Color Doppler ultrasound and contrast-enhanced abdominal computed tomography/magnetic resonance imaging are important auxiliary examinations for the diagnosis of portal vein thrombosis and play a vital role in early diagnosis and treatment,severity evaluation,and guidance for targeted treatment of this disease. Therapies of portal vein thrombosis depend on its severity and mainly target portal vein thrombosis and its complications. Surgical treatment should be performed for patients with intestinal congestion and necrosis,portal hypertension with esophagogastric variceal bleeding,splenomegaly,hypersplenism,portal hypertensive biliary disease,and end-stage liver disease. This article reviews the advances in the etiology,clinical manifestations,diagnosis,and surgical treatment of portal vein thrombosis.
作者
张鹰
刘庆艳
李志伟
ZHANG Ying, LIU Qingyan, LI Zhiwei(302 Hospital of PLA, Beijing 100039, China)
出处
《临床肝胆病杂志》
CAS
北大核心
2018年第10期2058-2062,共5页
Journal of Clinical Hepatology
关键词
静脉血栓形成
门静脉
外科治法
venous thrombosis
portal vein
surgical therapy
