实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (1): 113-116.doi: 10.3969/j.issn.1672-5069.2026.01.029

• 肝硬化 • 上一篇    下一篇

急性门静脉血栓形成诊治经验分享:15例病例报道与文献复习

丁靖诺, 赵卫峰, 赵法之   

  1. 610075 成都市 成都中医药大学附属医院全科医学科(丁靖诺);苏州大学附属第一医院感染病科(赵卫峰);电子科技大学附属肿瘤医院/四川省肿瘤医院研究所/四川省肿瘤临床医学研究中心/四川省癌症防治中心胃外科(赵法之)
  • 收稿日期:2025-02-25 出版日期:2026-01-10 发布日期:2026-02-04
  • 通讯作者: 赵法之,E-mail:zhaofz2015@foxmail.com
  • 作者简介:丁靖诺,女,28岁,硕士研究生,医师。E-mail: dingjingnuo_1112@163.com

Experience sharing of management of acute portal vein thrombosis:15 case report and literature review

Ding Jingnuo, Zhao Weifeng, Zhao Fazhi   

  1. Department of General Medicine, Affiliated Hospital, Traditional Chinese Medicine University, Chengdu 610075, Sichuan Province, China
  • Received:2025-02-25 Online:2026-01-10 Published:2026-02-04

摘要: 目的 分析和总结急性门静脉血栓形成(PVT)的临床特征和诊治经验。方法 2020年1月~2022年4月苏州大学第一附属医院诊治的急性PVT患者15例,接受常规化验和影像学检查,给予溶栓和抗凝治疗。结果 在15例患者中,男13例,女2例,平均年龄为(52.5±15.6)岁;乙型肝炎肝硬化5例,酒精性肝硬化1例,原发性胆汁性肝硬化1例,血吸虫病性肝硬化1例,不明原因肝硬化2例,非肝硬化患者5例(非硬化性门脉高压1例,遗传性蛋白C(PC)缺乏1例,未明确原因3例);给予抗凝治疗14例,其中行介入置管溶栓治疗2例,药物抗凝治疗1例;2例患者因并发肠缺血坏死合并感染性休克死亡,1例患者因EVB导致失血性休克死亡,1例患者接受治疗后在随访期间血栓无显著变化,2例患者出现血栓溶解、血管再通,其余患者在随访期间均可见血栓较前吸收、缩小。结论 急性PVT病因多样,缺乏特异的临床表现,早期发现,积极抗凝或介入溶栓治疗可降低病死率。

关键词: 急性门静脉血栓, 病因, 临床特征, 抗凝治疗

Abstract: Objective The purpose of this study was to summarize the clinical feature of patients with acute portal vein thrombosis (PVT). Methods 15 patients with acute PVT were admitted to The First Affiliated Hospital, Soochow University between January 2020 and April 2022, the etiology, clinical feature, treatments strategy and outcomes were summarized. Results Of the 15 patients with acute PVT, there were 13 males and 2 females, with an average age of (52.5±15.6) years; the etiology included hepatitis B-induced liver cirrhosis (LC) in 5 cases, alcoholic LC in 1 case, primary biliary cholangitis in 1 case, schistosomiasis-induced cirrhosis in 1 case and cryptogenic Cirrhosis in 2 cases, and non-cirrhotics, including non-cirrhotic portal hypertension in 1 case, hereditary protein C deficiency in 1 case and cryptogenic diseases in 3 cases; anticoagulation treatment was initiated in 14 cases, of which 2 patients received interventional thrombolysis and 1 patient received anticoagulation medicine treatment; 2 patients died of septic shock derived from intestinal ischemic necrosis, 1 patient died of hemorrhagic shock derived from esophageal variceal bleeding, PVT didn’t change in 1 case, thrombolysis and vascular recanalization occurred in 2 cases, and thrombosis shrunk in the remaining patients. Conclusion The etiology vary in patients with acute PVT, without specific clinical manifestations, and early diagnosis and intervention might improve the outcomes.

Key words: Acute portal vein thrombosis, Etiology, Clinical feature, Anticoagulation therapy