实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2014年
4期
429-432
,共4页
臧立娜(综述)%邢慧慧%王嘉菲%李明娟%刘晓峰(审校)
臧立娜(綜述)%邢慧慧%王嘉菲%李明娟%劉曉峰(審校)
장립나(종술)%형혜혜%왕가비%리명연%류효봉(심교)
门静脉血栓%肝硬化%发病机制%治疗
門靜脈血栓%肝硬化%髮病機製%治療
문정맥혈전%간경화%발병궤제%치료
Portal vein thrombosis%Liver cirrhosis%Mechanism%Treatment
肝硬化并发门静脉血栓(Portal vein thrombosis,PVT)将增加肝硬化并发症的发生率。由于PVT可与上消化道出血同时发生,增加了治疗的难度。PVT形成的主要原因是门静脉血流速度降低。目前,治疗PVT仍以药物为主,研究表明抗凝治疗并不增加消化道出血的风险,因此对于有适应症的患者,在食管胃静脉曲张经治疗消失后,应及时针对PVT进行治疗。部分脾动脉栓塞患者,在治疗后常规给予抗凝处理可减少门静脉血栓的发生。在治疗过程中,早期诊断、抗凝治疗的监测指标、肝素用量、预防复发方面仍有较多问题等待解决。
肝硬化併髮門靜脈血栓(Portal vein thrombosis,PVT)將增加肝硬化併髮癥的髮生率。由于PVT可與上消化道齣血同時髮生,增加瞭治療的難度。PVT形成的主要原因是門靜脈血流速度降低。目前,治療PVT仍以藥物為主,研究錶明抗凝治療併不增加消化道齣血的風險,因此對于有適應癥的患者,在食管胃靜脈麯張經治療消失後,應及時針對PVT進行治療。部分脾動脈栓塞患者,在治療後常規給予抗凝處理可減少門靜脈血栓的髮生。在治療過程中,早期診斷、抗凝治療的鑑測指標、肝素用量、預防複髮方麵仍有較多問題等待解決。
간경화병발문정맥혈전(Portal vein thrombosis,PVT)장증가간경화병발증적발생솔。유우PVT가여상소화도출혈동시발생,증가료치료적난도。PVT형성적주요원인시문정맥혈류속도강저。목전,치료PVT잉이약물위주,연구표명항응치료병불증가소화도출혈적풍험,인차대우유괄응증적환자,재식관위정맥곡장경치료소실후,응급시침대PVT진행치료。부분비동맥전새환자,재치료후상규급여항응처리가감소문정맥혈전적발생。재치료과정중,조기진단、항응치료적감측지표、간소용량、예방복발방면잉유교다문제등대해결。
The portal vein thrombosis (PVT) is a common complications in patients with liver cirrhosis. The upper gas-trointestinal hemorrhage usually occurs in patients with PVT. The main mechanism of PVT formation is the reduction of portal vein blood flow velocity. At present,medicine selection is priority to the management of PVT. Studies have shown that anticoagu-lant therapy does not increase the risk of gastrointestinal bleeding,and it is recommended that the patients having the indications should be given anticoagulants for PVT. The routine anticoagulation can reduce the incidence of portal thrombosis in patients having partial splenic artery embolization. So far,many problems are still need to be solved in early diagnosis,monitoring indexes for anticoagulation,the dosage of heparin and prevention of recurrence in dealing with patients with PVT.