门静脉海绵样变临床特点及病因分析.pdf

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1、·8·空堡{七像苤盍(电子题2年6旦第3卷第3期ChinJDigestMedImageol(ElectronicEdition)，June20l3，V01．3，No3．临床研究．门静脉海绵样变临床特点及病因分析杨齐詹雅诗黄晓丽柯比伦杨逸冬刘慧玲吴斌【摘要】目的分析门静脉海绵样变的临床特点与病因。方法收集2006年6月至2010年5月中山大学第三附属医院诊断为门静脉海绵样变的住院患者的临床资料，分析其临床特点并着重对其合并疾病进行回顾性分析。结果共83例患者纳入研究。患者主要因腹痛、上消化道出血入

2、院，临床有门脉高压及相应原发病表现，人院后多次彩色多普勒超声及CT／MRI检查后确诊为门静脉海绵样变。在83例患者中，合并肝硬化者60例，肝癌48例，腹部手术史者24例，肝动脉一门静脉瘘15例，糖尿病8例，布加综合征2例、胰腺癌2例。结论门脉高压并上消化道出血是门静脉海绵样变的主要临床特点；肝硬化及肝癌是门静脉海绵样变的重要病因，肝动脉一门静脉瘘及糖尿病可能是引起门静脉海绵样变的潜在病因。【关键词】门静脉海绵样变；肝硬化；肝肿瘤；肝动脉一门静脉瘘；糖尿病Clinicalcharactersand

3、etiologyofcavernoustransformationofportalveinYANGQi，ZHANYa—shi，HUANGXiao—li，KEBi—lun，YANGYi一如，LIUHui—ling，Bin．DepartmentofGastroenterology，ThirdAfiliatedHospitalofSunYat—senUniversity，Guangzhou510630，ChinaCorrespondingauthor：Bin，Email：binwuO01@hotmai

4、l．con【Abstract】0bjectiveToanalyzetheclinicalcharactersofcavernoustransformationofportalvein(CTPV)anditspotentialcauses．MethodsClinicaldataofpatientsdiagnosedasCTPVandtreatedinourhospitalfromJuneof2006toMayof2010werecollected．Theclinicalcharactersandc

5、omorbiditiesofCTPVwereanalyzedretrospectively．ResultsEighty·threepatientswereenrolledinthisresearch．Themainsymptomsofthesepatientswereabdominalpain，uppergastrointestinalhemorrhageandtheclinicalmanifestationcausedbyportalhypertensionandthecoresponding

6、originaldiseases．ThediagnosisofCTPVwasconfirmedaccordingtomorethanonceexaminationofcolordopplersonographyandCT／MRI．Amongthese83patients，complicationsincludedcirhosis(60cases)，hepatocarcinoma(48cases)，historyofabdominalsurgery(24cases)，hepaticartery—p

7、ortalveinfistula(HA—PVF，15cases)，diabetes(8cases)，Budd—Chiarisyndromeandpancreaticcarcinoma(2Casesforeach)．ConclusionsPortalhypertensioncomplicatedwithuppergastrointestinalhemorrhageisthemainclinicalcharacterofCTPV；cirrhosisandhepatocarcinomaarethema

8、incausesofCTPV，whileHA—PVFanddiabetesmaybeitspotentialcauses．【Keywords】Cavernoustransformationofportalvein；Livercirrhosis；Liverneoplasms；Hepaticartery—portalveinfistula；Diabetes门静脉海绵样变(cavernoustransformationofthe者研究显示其中有CTPV41例，约占3．2％。回顾portalvein，C