Li Zhenfang, Zhao Qi
Taishan Medical University, Liaocheng, Shandong Province, China.
Hepatogastroenterology. 2012 Nov-Dec;59(120):2587-91. doi: 10.5754/hge12264.
BACKGROUND/AIMS: The present study was performed to establish a scientific method for the typing of portal vein tumor thrombosis (PVTT) by investigating the degrees of esophageal-gastro varices, the incidences of rupturing hemorrhage and the prognoses of different types of patients with PVTT.
We collected 76 patients with HCC and PVTT in the People's Hospital of Liaocheng from March 2005 to July 2010 and divided them into two types by whether the PVTT exceeded the entry of vena coronaria ventriculi to the portal vein. All the patients were long-term followed-up until their deaths, and underwent upper-endoscopy and imaging inspection.
There was no significance for the comparison between the degrees of esophageal-gastro varices from the two types of PVTT Patients with type I PVTT had much higher incidences of rupturing hemorrhage than patients with type II. The principal cause of death of patients with type I was upper gastrointestinal hemorrhage while the principal cause of death of patients with type 11 was multiple organ failure including hepatic failure.
PVTT has developed quickly and its effect on the degrees of esophageal-gastro varices was insignificant in short-term.The prognoses of the patients with different types of PVTT were different. Our typing of PVTT could presume the prognoses of patients more conveniently and supply the theoretical evidence on the choices of treatments for various patients with PVTT.
背景/目的：本研究旨在通过调查食管胃静脉曲张程度、破裂出血发生率以及不同类型门静脉肿瘤血栓形成（PVTT）患者的预后，建立一种科学的PVTT分型方法。
我们收集了2005年3月至2010年7月聊城市人民医院76例肝癌合并PVTT患者，并根据PVTT是否超过胃冠状静脉汇入门静脉处将其分为两型。所有患者均进行长期随访直至死亡，并接受了上消化道内镜检查和影像学检查。
两型PVTT患者的食管胃静脉曲张程度比较无显著性差异。I型PVTT患者的破裂出血发生率明显高于II型患者。I型患者的主要死亡原因是上消化道出血，而II型患者的主要死亡原因是包括肝衰竭在内的多器官功能衰竭。
PVTT发展迅速，短期内对食管胃静脉曲张程度影响不明显。不同类型PVTT患者的预后不同。我们对PVTT的分型能够更方便地推测患者预后，并为不同PVTT患者治疗方案的选择提供理论依据。
