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肝硬化门静脉血栓形成的当前认知与管理

Current knowledge and management of portal vein thrombosis in cirrhosis.

作者信息

Senzolo Marco, Garcia-Tsao Guadalupe, García-Pagán Juan Carlos

机构信息

Multivisceral Transplant Unit-Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy(†).

Section of Digestive Diseases, VA-Connecticut Healthcare System, West Haven, CT, USA; Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT, USA.

出版信息

J Hepatol. 2021 Aug;75(2):442-453. doi: 10.1016/j.jhep.2021.04.029. Epub 2021 Apr 27.

Abstract

Portal vein thrombosis (PVT) is an increasingly recognised complication of cirrhosis whose incidence increases in parallel with the severity of cirrhosis. Several risk factors have been associated with the occurrence and progression of PVT. Although the negative effect of complete PVT on the surgical outcome of liver transplant recipients is clear, its impact on cirrhosis progression remains uncertain. Treatment options include anticoagulants and interventional thrombolytic therapies, which are chosen almost on a case-by-case basis depending on the characteristics of the patient and the thrombus. In this manuscript, we review current knowledge regarding the epidemiology, risk factors, diagnosis and classification, natural history, clinical consequences and treatment of non-neoplastic PVT in cirrhosis.

摘要

门静脉血栓形成(PVT)是肝硬化一种越来越被认识到的并发症,其发生率随肝硬化严重程度的增加而升高。多种危险因素与PVT的发生和进展相关。虽然完全性PVT对肝移植受者手术结局的负面影响是明确的,但其对肝硬化进展的影响仍不确定。治疗选择包括抗凝剂和介入溶栓治疗,几乎是根据患者和血栓的特点逐例选择。在本手稿中,我们综述了目前关于肝硬化中非肿瘤性PVT的流行病学、危险因素、诊断与分类、自然史、临床后果及治疗的相关知识。

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