Hoekstra J, Janssen H L A
Department of Gastroenterology and Hepatology (room Ha 206), Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Neth J Med. 2009 Feb;67(2):46-53.
Portal vein thrombosis (PVT) is a rare disorder that is associated with a variety of underlying conditions, of which liver cirrhosis, malignancy and myeloproliferative disorders are the most common. Based on clinical presentation and results of imaging, two different entities can be identified, acute and chronic PVT. Anticoagulation therapy is recommended for all patients with acute PVT in an attempt to prevent further thrombosis and to promote recanalisation of the obstructed veins. Chronic PVT is characterised by the presence of a portal cavernoma and development of portal hypertension. Bleeding from ruptured oesophageal or gastric varices is the main complication of portal hypertension in these patients. Both endoscopic therapy and beta-adrenergic blockade are used for the prevention and treatment of gastrointestinal bleeding. In the absence of bleeding, continuous anticoagulant therapy should be considered for the group of chronic PVT patients in whom an underlying prothrombotic factor can be identified. With adequate management of complications and concurrent diseases, prognosis of PVT is good in patients without underlying cirrhosis or malignancies.
门静脉血栓形成（PVT）是一种罕见疾病，与多种潜在病症相关，其中肝硬化、恶性肿瘤和骨髓增殖性疾病最为常见。根据临床表现和影像学检查结果，可识别出两种不同类型，即急性和慢性PVT。对于所有急性PVT患者，建议进行抗凝治疗，以防止进一步血栓形成并促进阻塞静脉的再通。慢性PVT的特征是存在门静脉海绵样变性和门静脉高压的发展。这些患者中，食管或胃静脉曲张破裂出血是门静脉高压的主要并发症。内镜治疗和β-肾上腺素能阻滞剂均用于预防和治疗胃肠道出血。在无出血的情况下，对于可识别出潜在血栓形成因素的慢性PVT患者群体，应考虑持续抗凝治疗。通过对并发症和并发疾病的充分管理，无潜在肝硬化或恶性肿瘤的PVT患者预后良好。
