附脐静脉开放对肝硬化食管静脉曲张发生及出血的影响:保护因素还是危险因素?  

Influence of patent paraumbilical vein on the development of esophageal varices and esophageal variceal bleeding in liver cirrhosis:A protective factor or a risk factor?

作　　者：陈智鹏 尹芳 CHEN Zhipeng;YIN Fang(Department of Gastroenterology,Xijing Hospital,Air Force Medical University,Xi’an 710032,China)

机构地区：[1]空军军医大学西京医院消化内科,西安710032

出　　处：《临床肝胆病杂志》2022年第4期918-922,共5页Journal of Clinical Hepatology

基　　金：王宝恩肝纤维化研究基金项目(20151028)。

摘　　要：既往研究认为,肝硬化门静脉高压时附脐静脉开放能够减少门静脉血流,降低门静脉压力,减少食管静脉曲张及出血的发生,但临床上对此尚存争论。本文从门静脉侧支循环形成及附脐静脉特点、附脐静脉开放定义及诊断、附脐静脉开放对食管静脉曲张发生及出血的影响等3个方面回顾总结,认为附脐静脉开放并不能够减少食管静脉曲张及出血的发生。与既往观点相反,附脐静脉开放更应作为肝硬化门静脉高压进展的一个表现,易导致肝性脑病的发生,临床上应注意针对性预防。Previous studies believe that patent paraumbilical vein in cirrhotic portal hypertension can reduce portal venous flow,portal venous pressure,and the development of esophageal varices and esophageal variceal bleeding,but there are still controversies over this issue in clinical practice.This article reviews the formation of portal systemic collateral circulation,the characteristics of the paraumbilical vein,the definition and diagnosis of patent paraumbilical vein,and the influence of patent paraumbilical vein on the development of esophageal varices and esophageal variceal bleeding,and it is believed that patent paraumbilical vein may not reduce the development of esophageal varices and esophageal variceal bleeding.Contrary to the previous points of view,patent paraumbilical vein should be regarded as a manifestation of the progression of cirrhotic portal hypertension,which can lead to the complications such as hepatic encephalopathy,and therefore,targeted prevention measures should be adopted in clinical practice.

关 键 词：肝硬化 高血压 门静脉 食管和胃静脉曲张 脐静脉 

分 类 号：R575.2[医药卫生—消化系统]