Division of Gastroenterology and Hepatology, UVA Center for the Study of Hemostasis and Thrombosis in Liver Disease, University of Virginia, Charlottesville, Virginia.
Semin Liver Dis. 2021 Jan;41(1):79-86. doi: 10.1055/s-0040-1722260. Epub 2021 Feb 9.
While portal vein thrombosis (PVT) is a frequently encountered complication in the cirrhosis population, its management can be challenging for even the most experienced clinicians. Multiple factors must be considered with regards to management, including the degree of underlying portal hypertension and liver dysfunction, risks of therapies including anticoagulation and transjugular intrahepatic portosystemic shunt placement, and extent of the thrombosis. Interpreting the available literature to determine the best treatment strategy for any individual patient can be especially challenging given the lack of prospective, randomized controlled trials and the heterogeneity of cohorts studied. This review will provide an overview of PVT in the cirrhosis population, including necessary steps in evaluation and the potential benefits and drawbacks of different treatment approaches.
虽然门静脉血栓形成(PVT)是肝硬化患者中常见的并发症,但即使是经验最丰富的临床医生,其管理也可能具有挑战性。在管理方面,需要考虑多个因素,包括潜在门静脉高压和肝功能障碍的程度、抗凝和经颈静脉肝内门体分流术放置等治疗方法的风险,以及血栓形成的程度。鉴于缺乏前瞻性、随机对照试验以及研究队列的异质性,解读现有文献以确定任何个体患者的最佳治疗策略可能特别具有挑战性。本综述将概述肝硬化患者的 PVT,包括评估中的必要步骤以及不同治疗方法的潜在益处和缺点。