门静脉高压性胆病的诊治进展

Advances in diagnosis and treatment of portal hypertensive biliopathy

随着近年来对门静脉高压的深入研究,门静脉高压性胆病(PHB)也引起了越来越多的关注。简要的介绍了PHB的病理生理改变、临床表现及主要诊疗方式。PHB的发病机理尚未完全明确,目前推测可能与门静脉海绵状血管瘤的压迫与缺血等因素相关。磁共振胰胆管成像是PHB首选的诊断手段,目前认为无症状的PHB患者无须治疗,症状性的PHB患者的治疗应强调其个体化,治疗的重点应以降低门静脉压力及解除胆道梗阻为主。目前经颈静脉肝内门体分流术等已经成为症状性PHB的一线治疗方法。PHB在临床上并不多见,对于它的了解与认识尚须要更多的实践与研究。

With the progress in research on portal hypertension in recent years, portal hypertensive biliopathy （PHB） has attracted more and more attention. The pathophysiology and clinical manifestations of PHB, as well as the main methods for the diagnosis and treatment of this disease, are briefly described. The pathogenesis of PHB remains unclear, and it has been postulated that the external pressure of portal cavernoma and the ischemic stricture of the bile duct may play a role. Magnetic resonance cholangiopancreatography is the primary diagnostic tool for PHB. Currently, it is thought that asymptomatic PHB patients do not require any treatment, and symptomatic PHB patients should receive individualized treatment, which mainly included reducing portal pressure and relieving biliary obstruction. Transjugular intrahepatic portosystemic shunt has become the first - line therapy for symptomatic PHB. More research and practice are needed for further understanding of PHB.