保护门静脉--从病理生理到临床处理决策  

Protect the portal vein:From pathophysiology to clinical decision making

作　　者：黄志寅[1] 高锦航[1,2] HUANG Zhiyin;GAO Jinhang(Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu 610041,China;Laboratory of Gastroenterology and Hepatology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院消化内科,成都610041 [2]四川大学华西医院消化疾病研究室,成都610041

出　　处：《临床肝胆病杂志》2021年第12期2760-2763,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81873584,82000613,82170623,82170625);成都市科技项目(2017-CY02-00023-GX)。

摘　　要：门静脉系统是肝脏的主要血供系统,肝硬化门静脉高压对门静脉系统的损伤可成为对肝脏的二次打击。保护门静脉才能保障肝脏的充分血供,维护其结构与功能。本文以门静脉生理结构和病理改变为切入点,通过门静脉系统血栓、异常血管新生、肝血窦内稳态失衡三个新的视角,阐述门静脉高压机制及对肝脏的负面影响。倡导改变临床上目前普遍被动应付门静脉高压并发症的现状,鼓励科学探索,多角度、早期降低门静脉高压,避免反复对侧支循环的内镜断流及脾脏切除术,减少各种对门静脉系统损伤的因素,维持门静脉系统的稳态,保护肝脏。The portal vein system is the main blood supply system of the liver,and damage to the portal vein system caused by cirrhotic portal hypertension may be the second hit to the liver.Protection of the portal vein will ensure sufficient blood supply of the liver and maintain its structure and function.Starting from the physiological structure and pathological changes of the portal vein,this article elaborates on the adverse effect of portal hypertension on the liver from the three new perspectives of thrombosis of the portal system,abnormal angiogenesis,and disturbance of hepatic sinusoidal homeostasis.It is suggested to change the current status of passive treatment of portal hypertension complications and encourage scientific exploration to reduce portal hypertension from multiple angles as early as possible to avoid repeated endoscopic devascularization of collateral circulation and splenectomy,so as to reduce various factors for the damage of the portal system,maintain the homeostasis of the portal system,and protect the liver.

关 键 词：高血压 门静脉 肝硬化 静脉血栓形成 新生血管化 病理性 

分 类 号：R575.2[医药卫生—消化系统]