[1]薛文豪,刘仕睿,徐 鹏,等.介入治疗门静脉海绵样变性的中期疗效分析[J].介入放射学杂志,2026,(04):385-389.[doi:10.3969/j.issn.1008-794X.2026.04.007 ]
　XUE Wenhao,LIU Shirui,XU Peng,et al.Interventional therapy for cavernous transformation of portal vein: analysis of its mid-term efficacy[J].J Intervent Med,2026,(04):385-389.[doi:10.3969/j.issn.1008-794X.2026.04.007 ]
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介入治疗门静脉海绵样变性的中期疗效分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年04
页码:
385-389
栏目:
血管介入
出版日期:
2026-04-25

文章信息/Info

Title:
Interventional therapy for cavernous transformation of portal vein: analysis of its mid-term efficacy
文章编号:
1008-794X(2026)-004-0385-05
作者:
薛文豪;  刘仕睿;  徐 鹏;  化召辉;  焦周阳;  曹 辉;  李 震
450052 河南郑州 郑州大学第一附属医院腔内血管外科
Author(s):
XUE Wenhao; LIU Shirui; XU Peng; HUA Zhaohui; JIAO Zhouyang; CAO Hui; LI Zhen.
Department of Endovascular Surgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China
关键词:
门静脉海绵样变性;  门静脉血栓;  经颈静脉肝内门体分流术;  门静脉再通术
分类号:
R657.3+4
DOI:
10.3969/j.issn.1008-794X.2026.04.007
文献标志码:
A
摘要:
目的 分析门静脉海绵样变性(CTPV)的特点及介入治疗的效果。方法 纳入2017年6月至2023年6月郑州大学第一附属医院介入治疗的CTPV患者84例,根据治疗方式及是否合并肝硬化分为肝硬化经颈静脉肝内门体分流术(TIPS)组36例,非肝硬化TIPS组36例,非肝硬化门静脉支架植入组12例。比较各组患者临床特点及并发症发生情况。Kaplan-Meier法绘制生存曲线,采用log-rank检验比较组间支架通畅率及患者总生存率。结果 3组患者的白细胞计数、红细胞计数、凝血酶原时间,以及总胆红素、出血、腹痛、腹水占比差异有统计学意义(均P<0.05)。肝硬化TIPS组院内死亡2例,34例患者随访24(19,36)个月,随访期间死亡2例、15例支架闭塞、4例再出血、7例再发腹痛、2例出现显性肝性脑病; 非肝硬化TIPS组院内死亡5例,31例患者随访29(19,35)个月,随访期间死亡4例、25例支架闭塞、7例再出血、11例再发腹痛; 非肝硬化门静脉支架植入组12例患者,随访23.5(18.5,28.8)个月,随访期间死亡1例、7例支架闭塞、3例再出血、4例再发腹痛; 3组间并发症发生率差异无统计学意义(均P>0.05)。Kaplan-Meier生存曲线显示肝硬化TIPS组支架通畅率优于非肝硬化TIPS及门静脉支架植入组(P<0.05),3组间生存状态差异无统计学意义(χ2=0.341,P=0.843)。结论 介入是CTPV的有效治疗方式之一,但术后并发症较多,且非肝硬化患者支架闭塞率较高。

参考文献/References:

[1] Elkrief L,Houssel-Debry P,Ackermann O,et al.Portal cavernoma or chronic non cirrhotic extrahepatic portal vein obstruction[J].Clin Res Hepatol Gastroenterol,2020,44:491-496.
[2]薛文豪,化召辉,李 震,等.门静脉海绵样变性的诊治进展[J].中华血管外科杂志,2024,09:122-128.
Advances in the diagnosis and treatment of cavernous transformation of the portal vein[J].Chinese Journal of Vasular Surgery,2024,09:122-128.
[3]de Franchis R,Bosch J,Garcia-Tsao G,et al.Baveno Ⅶ-Renewing consensus in portal hypertension[J].J Hepatol,2022,76:959-974.
[4]Li ZP,Wang SS,Wang GC,et al.Transjugular intrahepatic portosystemic shunt for the prevention of recurrent esophageal variceal bleeding in patients with cavernous transformation of portal vein[J].Hepatobiliary Pancreat Dis Int,2018,17:517-523.
[5]Denys A,Artru F.Noncirrhotic Portal Vein Cavernous Transformation:To TIPS,or Not to TIPS,That Is the Question[J].J Vasc Interv Radiol,2023,34:195-196.
[6]De Gaetano AM,Lafortune M,Patriquin H,et al.Cavernous transformation of the portal vein:patterns of intrahepatic and splanchnic collateral circulation detected with Doppler sonography[J].AJR Am J Roentgenol,1995,165:1151-1155.
[7]Zhou Y,Zhuang Z,Yu T,et al.Long-term efficacy and safety of anticoagulant for cavernous transformation of the portal vein cirrhotic patient with extrahepatic portal vein obstruction[J].Thromb J,2023,21:6.
[8]Elkrief L,Hernandez-Gea V,Senzolo M,et al.Portal vein thrombosis:diagnosis,management,and endpoints for future clinical studies[J].Lancet Gastroenterol Hepatol,2024,9:859-883.
[9]Bi Y,Ren J,Han X,et al.Combined transjugular/percutaneous intrahepatic portosystemic shunts(cTIPS)for cavernous transformation of the portal vein after conventional transjugular approach TIPS failure[J].Medicine(Baltimore),2023,102:e33608.
[10]宋德洋,李卫校,徐如涛,等.AngioJet血栓抽吸联合经颈静脉肝内门体分流术治疗急性门静脉系统血栓形成效果分析[J].介入放射学杂志,2022,31:236-241.
Song DY,Li WX,Xu RT,et al.AngioJet thrombus aspiration combined with TIPS for the treatment of acute portal venous systemic thrombosis:analysis of curative effect[J].J Interv Radiol,2022,31:236-241.
[11]Tie J,Gou X,He C,et al.Transjugular intrahepatic collateral-systemic shunt is effective for cavernous transformation of the portal vein with variceal bleeding[J].Hepatol Int,2023,17:979-988.
[12]温 晨,袁 凯,马鹍鹏,等.经颈静脉肝内门体分流术治疗门静脉高压伴门静脉血栓的疗效与安全性[J].介入放射学杂志,2024,33:537-542.
Wen C,Yuan K,MA KP,et al.Transjugular intrahepatic portosystemic shunt for portal hypertension with portal vein thrombosis:analysis of its efficacy and safety[J].J Interv Radiol,2024,33:537-542.
[13]Rodrigues SG,Sixt S,Abraldes JG,et al.Systematic review with meta-analysis:portal vein recanalisation and transjugular intrahepatic portosystemic shunt for portal vein thrombosis[J].Aliment Pharmacol Ther,2019,49:20-30.
[14]Dulcetta L,Marra P,Muglia R,et al.Percutaneous management of chronic total occlusion of the portal vein:a retrospective analysis of technical aspects and outcomes[J].CVIR Endovasc,2024,7:81.
[15]Wei B,Huang Z,Wu H,et al.Portal vein recanalization for noncirrhotic portal vein cavernous transformation:transjugular intrahepatic portosystemic shunt creation versus portal vein stent placement[J].J Vasc Interv Radiol,2023,34:187-194.
[16]Marot A,Barbosa JV,Duran R,et al.Percutaneous portal vein recanalization using self-expandable nitinol stents in patients with non-cirrhotic non-tumoral portal vein occlusion[J].Diagn Interv Imaging,2019,100:147-156.
[17]Stancu B,Chira A,Coman HF,et al.Intestinal obstruction as initial presentation of idiopathic portal and mesenteric venous thrombosis:diagnosis,management,and literature review[J].Diagnostics(Basel),2024,14:304.
[18]Wei B,Huang Z,Tang C.Optimal treatment for patients with cavernous transformation of the portal vein[J].Front Med(Lausanne),2022,9:853138.
[19]Rössle M,Bettinger D,Trebicka J,et al.A prospective,multicentre study in acute non-cirrhotic,non-malignant portal vein thrombosis:comparison of medical and interventional treatment[J].Aliment Pharmacol Ther,2020,52:329-339.
[20]Kim HK,Hwang D,Park S,et al.Treatment outcomes and risk factors for bowel infarction in patients with acute superior mesenteric venous thrombosis[J].J Vasc Surg Venous Lymphat Disord,2017,5:638-646.
[21]Attanasi ML,Bou Daher H,Rockey DC.Natural history and outcomes of cavernous transformation of the portal vein in cirrhosis[J].Dig Dis Sci,2023,68:3458-3466.
(收稿日期:2025-01-13)
(本文编辑:新 宇)

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备注/Memo

备注/Memo:
基金项目: 国家自然科学基金(82370503)
通信作者: 李 震 E-mail:lizhen1029@hotmail.com
更新日期/Last Update: 2026-04-25