临床肝胆病杂志2026，Vol.42Issue(4)：748-754,7.DOI:10.12449/JCH260402
门静脉血栓的诊断和治疗
Diagnosis and treatment of portal vein thrombosis
摘要
Abstract
Portal vein thrombosis(PVT)involves the main portal vein and its tributaries,and acute PVT can cause intestinal ischemia and necrosis,while chronic PVT can cause cavernous transformation of the portal vein and portal hypertension-related complications(such as ascites and gastroesophageal variceal bleeding).Liver cirrhosis is the main risk factor for PVT.the Classification of PVT provides a basis for clinical diagnosis.Ultrasound is the preferred method for screening,and contrast-enhanced computed tomography is the gold standard for diagnosis,while magnetic resonance imaging/magnetic resonance venography can help to identify acute or chronic thrombosis.Treatment emphasizes individualized strategies:anticoagulant therapy is the first-line therapy for acute PVT,and direct oral anticoagulants have shown great potential in clinical practice;thrombolytic therapy is appropriate for severe acute PVT,and it is needed to strictly control the risk of bleeding;transjugular intrahepatic portosystemic shunt is an important method for the diagnosis and treatment of PVT-related ascites and gastroesophageal variceal bleeding;surgical operation can be used for the treatment of patients with no response to pharmacotherapy or those with serious complications such as intestinal necrosis.Future diagnosis and treatment of PVT should be based on multidisciplinary collaboration,focusing on the optimization of individualized regimens,balancing efficacy and safety,and continuously leveraging technological advances to improve clinical practice.关键词
门静脉血栓/诊断/治疗学Key words
Portal Vein Thrombosis/Diagnosis/Therapeutics引用本文复制引用
何雨芩,文良志..门静脉血栓的诊断和治疗[J].临床肝胆病杂志,2026,42(4):748-754,7.基金项目
国家自然科学基金(82273484,82473105) （82273484,82473105）
重庆市中青年医学高端人才项目资助 National Natural Science Foundation of China(82273484,82473105) （82273484,82473105）
Chongqing Young and Middle-aged Medical Talents Project （）
