门静脉血栓形成对肝硬化病程发展影响

Effect of portal vein thrombosis on the course of liver cirrhosis

目的探讨门静脉血栓(PVT)形成对肝硬化病程的影响。方法回顾我院2003年～2011年肝硬化伴PVT形成的患者资料。18例肝硬化伴PVT形成患者入选血栓组;随机选择同阶段肝硬化门静脉高压症的无门静脉血栓形成患者19例作为对照组,比较两组患者的门静脉宽度、脾脏厚度、食管胃底静脉曲张、腹水及上消化道大出血发生等情况。结果血栓组的门静脉宽度及脾脏厚度大于对照组,差异有统计学意义(P<0.05)。血栓组食管胃底重度静脉曲张、上消化道大出血和大量腹水比例两组比较,差异有统计学意义(P<0.05)。结论脾肿大和门静脉增宽是PVT形成的主要危险因素,PVT形成加重门静脉高压的程度,从而增加上消化道出血几率,使腹水难以消退,增加相关并发症发生率并使相关症状加重,预防门静脉血栓形成有助于延缓肝硬化病情发展。

Objective To investigate the effect of portal vein thrombosis （PVT） on nature course of liver cirrhosis （LC） . Methods Patients with LC during 2003 - 2011 were reviewed, eighteen cases of LC with PVT, nineteen cases of LC patients without PVT were chosen. The average diameter of main portal vein （MPV） , spleen thickness, the store-ach esophagus varicosity, ascites etc were compared between the two groups. Results Width of the portal vein and spleen thickness were greater in study group than those in the control group （P 〈 O. 05）. Compared with control group, more severe esophageal varies, higher rate of sever variceal haemorrhage and larger volume of ascites after portal vein thrombosis were shown in the study group （P 〈 0.05）. Conclusion The splenomegaly and broadening of portal vein are the main risk factors caused PVT, which further increase portal hypertension and the risk of gastrointestinal bleeding.