脾切除断流术后门静脉系统血栓形成的诊疗对策  

Diagnosis and Treatment Countermeasures of Portal Vein Thrombosis after Splenectomy and Pericardial De-vascularization

作　　者：郭宏伟[1,2] 谭文翔[1,2] 付维利[1,2] 刘小北[1,2] 

机构地区：[1]大连市友谊医院肝胆外科 [2]大连市肝胆外科研究所,辽宁大连116001

出　　处：《医学与哲学（B）》2013年第9期84-86,共3页Medicine & Philosophy(B)

摘　　要：门静脉系统血栓(portal vein thrombosis,PVT)可导致流向肝脏的血流减少和门静脉压力增高,损害肝脏功能的同时增加消化道出血的风险,肠系膜上静脉的血栓更能造成小肠的广泛坏死。目前研究表明,肝硬化脾脏切除断流术后门静脉血栓有很高的发生率,越来越受到人们的重视,门静脉系统血流动力学改变是PVT形成的主要原因;彩超、CT和MRI等有针对性检查可减少误诊和漏诊,重要的是尽早地确诊,术后早期抗凝可有效地避免血栓发生,预防和治疗需要按照循证医学的原则制定规范的方案。Portal vein thrombosis （PVT） can decrease the liver blood flow and increased portal pressure, damage to the liver and increased risks of gastrointestinal bleeding, superior mesenteric vein thrombosis more can cause small bowel necrosis. Research shows that at present, there is a high incidence of portal vein thrombosis after splenectomy and pericardial de-vascularization for portal hypertension due to hepatic cirrhosis, more and more attention be taken seriously, portal system thermodynamics change is a major cause of portal vein thrombosis; It is important to early diagnosis, color doppler, CT and MRI targeted examination can reduce the misdiagnosis and missed diagnosis, and early postoperative anti- coagulation can effectively avoid thrombosis, regulation for prevention and treatment is needed according to the principle of evidence-- based medicine.

关 键 词：脾切除术 断流术 门静脉系统血栓 

分 类 号：R543.6[医药卫生—心血管疾病] R619[医药卫生—内科学]