门静脉血栓影响肝硬化进程与食管胃静脉曲张处理

Portal vein thrombosis affects the progress of liver cirrhosis and the treatment of esophageal and gastric varices

门静脉血栓(portal vein thrombosis,PVT)是指门静脉主干管腔内血栓形成,可延伸至门静脉左右分支,引起门静脉回流受阻,严重时完全堵塞。在普通人群中,PVT发生少见,约为1%。在肝硬化患者中,尤其是门脉高压患者,PVT是一种常见的并发症,发生率随着门脉高压的进展增加。PVT的进展增加了门脉压力和食管胃静脉曲张的出血风险。阐明PVT在肝硬化进程中的作用及合并食管胃静脉曲张的处理策略,是早期识别PVT的演变、寻找启动治疗的最佳时机、减少患者出血风险、改善患者预后的关键。

Portal vein thrombosis(PVT)refers to the thrombosis in the main lumen of the portal vein,which can extend to the left and right branches of the portal vein,causing the portal vein reflux to be blocked,or even completely blocked in severe cases. In the general population,PVT is rare,about 1%. PVT is a common complication in patients with liver cirrhosis,especially in patients with portal hypertension,and its incidence increases with the progress of portal hypertension. The progress of PVT increases the portal pressure and the risk of bleeding from esophageal and gastric varices.To clarify the role of PVT in the process of liver cirrhosis and the treatment strategy of esophageal and gastric varices is the key to early identify the evolution of PVT,find the best time to start treatment,reduce the risk of bleeding and improve the prognosis of patients.