摘要
<正>门静脉高压症是指门静脉系统压力升高(术中直接测定门静脉自由压超过22mmHg,或门静脉与下腔静脉之间压力差超过5mmHg)所引起的一组临床综合征,主要表现为脾大、脾功能亢进、门体侧支循环形成、食管胃静脉曲张及破裂出血。在所有门脉高压症患者中,肝硬化所导致的窦性门脉高压约占90%,而非肝硬化性门脉高压仅占10%左右。后者包括肝(窦)前性门脉高压症如门静脉系统血栓形成、门静脉闭锁、先
引文
[ 1 ] de Franchis R. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol,2015,63: 743-752.
[ 2 ] European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Vascular diseases of the liver. J Hepatol,2016,64: 179-202.
[ 3 ] MartínLlahí M, Albillos A, Baňares, et al. Vascular diseases of the liver. Clinical Guidelines from the Catalan Society of Digestology and the Spanish Association for the Study of the Liver. Gastroenterol Hepatol,2017,40: 538-580.
[ 4 ] Khanna R, Sarin SK. Idiopathic portal hypertension and extrahepatic portal venous obstruction. Hepatol Int,2018,12: 148-167.
[ 5 ] Khanna R, Sarin SK. Non-cirrhotic portal hypertension-diagnosis and management. J Hepatol,2014,60: 421-441.
[ 6 ] Lee H, Rehman AU, Fiel MI. Idiopathic Noncirrhotic Portal Hypertension: An Appraisal. J Pathol Transl Med,2016,50: 17-25.
[ 7 ] Siramolpiwat S, Seijo S, Miquel R, et al. Idiopathic portal hypertension: natural history and long-term outcome. Hepatology,2014,59: 2276-2285.
[ 8 ] Zuo C, Chumbalkar V, Ells PF, et al. Prevalence of histological features of idiopathic noncirrhotic portal hypertension in general population: a retrospective study of incidental liver biopsies. Hepatol Int,2017,11: 452-460.
[ 9 ] Guido M, Sarcognato S, Sacchi D, et al. Pathology of idiopathic non-cirrhotic portal hypertension. Virchows Arch,2018,473: 23-31.
[10] Guido M, Alves V AF, Balabaud C, et al. Histology of portal vascular changes associated with idiopathic non-cirrhotic portal hypertension: nomenclature and definition. Histopathology 2019,74:219-226.
[11] Rajesh S, Mukund A, Sureka B, et al. Non-cirrhotic portal hypertension: an imaging review. Abdom Radiol (NY),2018,43: 1991-2010.
[12] Maruyama H, Shimada T, Ishibashi H, et al. Delayed periportal enhancement: a characteristic finding on contrast ultrasound in idiopathic portal hypertension. Hepatol Int,2012,6: 511-519.
[13] Seijo S, Lozano JJ, Alonso C, et al. Metabolomics discloses potential biomarkers for the noninvasive diagnosis of idiopathic portal hypertension. Am J Gastroenterol, 2013,108: 926-932.
[14] Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology,2017, 65: 310-335.
[15] Regnault D, D′alteroche L, Nicolas C, et al. Ten-year experience of transjugular intrahepatic portosystemic shunt for noncirrhotic portal hypertension. Eur J Gastroenterol Hepatol,2018,30: 557-562.