肝硬化门静脉血栓形成的临床诊治进展  

Progress in Diagnosis and Treatments of Portal Vein Thrombosis in Liver Cirrhosis

作　　者：刘娟娟[1,2] 薛挥 LIU Juanjuan;XUE Hui(Division of Gastroenterology and Hepatology,the First Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710061,China;Division of the First Internal Medicine,Xi′an Central Hospital of China Railway First Group,Xi′an 710054,China)

机构地区：[1]西安交通大学第一附属医院消化内科,西安710061 [2]中铁一局西安中心医院内一科,西安710054

出　　处：《医学综述》2019年第2期326-330,共5页Medical Recapitulate

摘　　要：门静脉血栓形成(PVT)是肝硬化最常见的严重并发症之一。早期诊断和及时治疗可显著降低肝硬化患者PVT相关的临床风险。目前,影像学检查是确诊肝硬化PVT的主要依据,但不同方法对于PVT的诊断价值不同。门静脉超声是临床首选检查,血管造影是诊断PVT的金标准,但因有创而不作为常规检查,门静脉CT血管成像或磁共振血管成像可作为手术治疗前评价PVT的主要手段。肝硬化PVT的治疗以抗凝为主,包括溶栓、血管介入、外科手术等,抗凝首选低分子肝素,应定期评估出血和血栓形成风险。随着大型多中心随机对照临床试验的进展,将会对肝硬化PVT的综合诊治提供更多依据与指导。Portal vein thrombosis(PVT)is one of the most common complications of liver cirrhosis.Early diagnosis and prompt treatment can significantly decrease the risks of PVT in liver cirrhosis.At present,imaging examination is a major basis for PVT diagnosis,but different examinations have their own specific diagnostic values.Portal vein ultrasonography is the first choice for detecting PVT in common patients.Portal venography as a gold standard for PVT diagnosis,should not be used widely for general patients because of its invasion.CT angiography or magnetic resonance angiography can be employed to evaluate PVT before surgery.Anticoagulation is a basic and preferred selection for PVT among all treatments including thrombolysis,intervention procedures and surgery.Low molecular weight heparin is usually used for anticoagulation.Risks of bleeding and thrombosis should be periodically evaluated during anticoagulation.Along with progress of more multicenter random clinical trials,more reference and guidance will be provided for the diagnosis and treatment of liver cirrhosis associated PVT.

关 键 词：肝硬化 门静脉血栓形成 溶栓 

分 类 号：R575[医药卫生—消化系统]