门静脉海绵样变性的临床诊疗进展

Progress in clinical diagnosis and treatment of cavernous transformation of the portal vein

门静脉海绵样变性(cavernous transformation of portal vein,CTPV)是指门静脉主干或其分支受阻后,机体为维持肝脏血流灌注,在肝门区代偿性形成的大量海绵样侧支血管丛.该病较罕见,临床实践中缺乏对其病因及诊疗原则的认识.对于出现门静脉高压相关症状的患者需要采取积极治疗措施.治疗的主要目的是防治门静脉高压引起的上消化道出血和脾功能亢进,以及恢复肝脏门静脉血流灌注.需要在充分了解患者病情及每种治疗方式最佳适应症的基础上,采用个体化综合治疗策略.本文就CTPV的病因、诊断、分型、治疗方面的最新进展作一综述.

Cavernous transformation of the portal vein(CTPV)refers to the compensatory neoformation of venous collaterals around the hepatic portal after the main portal vein or its branches are blocked,in order to maintain liver blood perfusion.This disease is relatively rare,and in clinical practice,its etiology,diagnosis,and treatment are not well understood.Patients with portal hypertension-related syndromes need to receive active treatment.The main goal of treatment is to prevent upper gastrointestinal hemorrhage and hypersplenism caused by portal hypertension,and to restore hepatopetal portal blood perfusion.It is necessary to fully assess the patient’s condition and understand the best indications for each treatment.On this basis,we should adopt individualized comprehensive treatment strategies.This article reviews the latest advances in the understanding of the etiology,diagnosis,classification,and treatment of CTPV.