门静脉高压症CEAP诊断系统的建立

Establishment of CEAP system for the diagnosis of portal hypertension

目的建立门静脉高压症(PH)CEAP诊断系统。方法回顾性分析我院收治的251例PH患者的临床和病理资料,参照美国静脉论坛关于下肢慢性静脉性病变的诊断和治疗分类系统中的临床、病因、解剖、病理生理(CEAP)和布-加综合征的许氏临床病理分型,提出PH的CEAP诊断系统。结果根据影像学(多普勒超声、经皮脾穿刺门静脉造影、选择性肠系膜上动脉造影或多排螺旋CT三维重建)检查结果和临床以及病理学资料,将PH的CEAP诊断系统归纳为:临床表现(C)分为轻型和重型;病因(E)则有先天性、原发性和后天性;解剖(A)定位于肝脏、腔静脉、肝静脉和门静脉系;病理生理(P)变化包括肝脏的纤维化或硬化、血管的阻塞和血栓形成以及肝内侧支形成、肿瘤(Pt)等。结论 CEAP诊断系统的建立对各种原因引起的PH的正确诊断、分型和个体化的治疗对策中具有重要的意义,有较高的临床应用和推广价值。

Objective To set up CEAP system for the diagnosis of portal hypertention.Methods Based on CEAP system from American Venous Forum,the clinical and pathologic classification of Budd-Chiari syndrome from Xu,the clinical and pathologic data of 251 cases of portal hypertension were analyzed retrospectively.Results According to the results of imaging examination [（Doppler ultrasound,percutaneous splenoportography,selective angiography of mesenteric artery,multi-slice spiral CT（MSCT） three dimensional（3D） reconstruction],clinical and pathological data,CEAP system for the diagnosis of portal hypertention was defined as follows： Clinical manifestation（C） including mild and severe types;Etiology（E）（congenital,primary,secondary）;Anatomy（A） consists of liver,inferior vena cava,hepatic veins,and portal vein system;Pathophysiology（P） could have liver fibrosis/cirrhosis,obstruction,thrombosis,intrahepatic collateral circulation and tumors.Conclusions CEAP system for correct diagnosis,classification as well as the individual treatment is of great practical importance,and could be wide application.