肝硬化并发门静脉血栓研究进展

Progress in portal vein thrombosis in patients with liver cirrhosis

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。

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.