Sogaard Kirstine K, Astrup Lone B, Vilstrup Hendrik, Gronbaek Henning
Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Aarhus C, Denmark.
BMC Gastroenterol. 2007 Aug 15;7:34. doi: 10.1186/1471-230X-7-34.
Portal vein thrombosis (PVT) is increasingly frequently being diagnosed, but systematic descriptions of the natural history and clinical handling of the condition are sparse. The aim of this retrospective study was to describe risk factors, clinical presentation, complications and treatment of portal vein thrombosis in a single-centre.
Sixty-seven patients were identified in the electronic records from 1992 to 2005. All data were obtained from the patient records.
One or more risk factors (e.g. prothrombotic disorder or abdominal inflammation) were present in 87%. Symptoms were abdominalia, splenomegaly, fever, ascites, haematemesis, and weight loss. Abdominalia and fever occurred more frequently in patients with acute PVT. Frequent complications were splenomegaly, oesophageal- and gastric varices with or without bleeding, portal hypertensive gastropathy and ascites. Varices and bleeding were more frequent in patients with chronic PVT. Patients who received anticoagulant therapy more frequently achieved partial/complete recanalization. Patients with varices who were treated endoscopically in combination with beta-blockade had regression of the varices. The overall mortality was 13% in one year, and was dependent on underlying causes.
Most patients had a combination of local and systemic risk factors for PVT. We observed that partial/complete recanalization was more frequent in patients treated with anticoagulation therapy, and that regression of varices was more pronounced in patients who where treated with active endoscopy combined with pharmacological treatment.
门静脉血栓形成（PVT）的诊断日益常见，但对该疾病自然史和临床处理的系统描述却很匮乏。这项回顾性研究的目的是描述单中心门静脉血栓形成的危险因素、临床表现、并发症及治疗情况。
从1992年至2005年的电子记录中识别出67例患者。所有数据均从患者记录中获取。
87%的患者存在一个或多个危险因素（如血栓前状态或腹部炎症）。症状包括腹痛、脾肿大、发热、腹水、呕血和体重减轻。腹痛和发热在急性PVT患者中更常见。常见并发症有脾肿大、伴或不伴出血的食管和胃静脉曲张、门静脉高压性胃病和腹水。静脉曲张和出血在慢性PVT患者中更常见。接受抗凝治疗的患者更常实现部分/完全再通。接受内镜治疗联合β受体阻滞剂治疗的静脉曲张患者，静脉曲张有所消退。一年总体死亡率为13%，且取决于潜在病因。
大多数患者存在PVT的局部和全身危险因素。我们观察到，接受抗凝治疗的患者更常出现部分/完全再通，而接受积极内镜检查联合药物治疗的患者，静脉曲张消退更为明显。
