胰源性门静脉高压的临床诊断和治疗研究进展

doi:10.20223/j.cnki.1000-8535.2025.02.016

摘要/Abstract

摘要： 胰源性门静脉高压（PSPH）是由脾静脉（SV）流通受阻引起的一种临床综合征,在临床较为罕见且对患者造成生命威胁,但却为门静脉高压唯一可治愈的类型。其主要发病诱因是胰腺原发疾病,通常为胰腺急（慢）性炎症、胰腺占位性病变和胰腺手术操作导致。1型孤立性食管胃底静脉曲张、脾大、脾功能亢进是PSPH的主要临床表现特征,其中食管胃底曲张静脉破裂出血是PSPH最为严重的并发症;患者若表现为肝功能正常但出现原因不明脾肿大并伴有消化道出血症状,应考虑可能出现了PSPH。PSPH的治疗可分为胰腺原发病、门静脉高压及并发症的综合性诊治。本文旨在回顾PSPH的相关文献,对其有关临床诊断与治疗现状进行综述,以期指导医务工作者在临床中尽早发现PSPH并对患者及时有效治疗。

关键词: 胰源性门静脉高压, 脾静脉, 胰腺炎, 胰腺肿瘤, 超声内镜

Abstract: Pancreatic segmental portal hypertension（PSPH）is a clinical syndrome caused by spleen vein（SV） occlusion or stenosis．It is a rare and life-threatening hemorrhagic disease of the upper digestive tract,but it is the only curable type of portal hypertension．The main cause is primary pancreatic disease,which is usually due to acute or chronic pancreatic inflammation,pancreatic space-occupying lesions and pancreatic surgery．Type 1 isolated esophagogastric varices,splenomegaly and hypersplenism are the main clinical features of PSPH,and esophagogastric variceal bleeding is the most serious complication of PSPH．PSPH should be considered in patients with normal liver function but unexplained splenomegaly accompanied by gastrointestinal bleeding．The treatment of PSPH can be divided into a comprehensive diagnosis and treatment of primary pancreatic disease,portal hypertension and complications．Therefore,the purpose of this paper is to review relevant literature of PSPH,the relevant clinical diagnosis and treatment status quo were summerized,in order to guide the medical workers in clinical PSPH,early detection and timely and effective treatment for patients．

Key words: pancreatic segmental portal hypertension, splenic vein, pancreatitis, pancreatic neoplasms, endoscopic ultrasonography

王灏, 袁宏伟, 刘校伸, 杜磊, 王志鑫. 胰源性门静脉高压的临床诊断和治疗研究进展[J]. 广州医药, 2025, 56(2): 247-251.

WANG Hao, YUAN Hongwei, LIU Xiaoshen, DU Lei, WANG Zhixin. Progress in clinical diagnosis and treatment of pancreatic segmental portal hypertension[J]. Guangzhou Medical Journal, 2025, 56(2): 247-251.

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