Morag Iris, Epelman Monica, Daneman Alan, Moineddin Rahim, Parvez Boriana, Shechter Tal, Hellmann Jonathan
Division of Neonatology and Diagnostic Imaging, Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
J Pediatr. 2006 Jun;148(6):735-9. doi: 10.1016/j.jpeds.2006.01.051.
To determine the risk factors, clinical features, and outcome of infants diagnosed with portal vein thrombosis (PVT).
A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT.
PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter (UVC) was inserted in 73% of the infants and was in an appropriate position in 46% of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27% of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome.
PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improperly placed UVC and with grade 3 thrombus.
确定诊断为门静脉血栓形成（PVT）的婴儿的危险因素、临床特征及预后。
对1999年1月至2003年12月间收治于多伦多病童医院且诊断为PVT的所有连续婴儿进行回顾性病历审查。
133例婴儿被诊断为PVT，其中除5例之外均为新生儿，诊断时的中位年龄为7天。73%的婴儿插入了脐静脉导管（UVC），其中46%位置合适。27%的婴儿被诊断为预后不良，定义为门静脉高压或肝叶萎缩，在最初诊断为3级PVT的婴儿以及UVC位置较低或位于肝内的婴儿中更为常见。抗凝治疗似乎对预后没有显著影响。
PVT在生命早期发生；除新生儿期外，主要危险因素是UVC的放置和严重的新生儿疾病。预后不良与UVC放置不当及3级血栓有关。
