???????????????????γ?????Σ???17???????????

目的 探讨肝硬变病人门静脉系统血栓形成的诊断和治疗。方法 对17例肝硬变门静脉系统血栓形成病人的诊断和治疗进行回顾性分析。结果 本组肝硬变病人断流和（或）分流术后门静脉系统血栓形成发生率为18．68％（17／91）。彩色多普勒超声检查确诊7例，CT确诊2例，肠系膜血管造影确诊2例，开腹探查确诊6例。9例经溶栓治疗临床治愈，8例行肠切除Fogarty管取栓术，死亡1例。结论 对于肝硬变特别是断流和（或）分流术后病人出现腹胀、腹痛、腹泻者应注意门静脉系统血栓形成的可能；彩色多普勒超声和动态多时相CT有助于早期诊断；早期诊断和积极溶栓治疗有助于防止肠管坏死的发生；出现肠坏死、腹膜炎者应切除坏死肠管及有血栓的肠系膜，同时继续抗凝祛聚治疗。

Diagnosis and treatment of portal vein thrombosis after the operation of hepatic cirrhosis: a clinical analysis of 17 cas

Objective To discuss the diagnosis and treatment of portal vein thrombosis(PVT)caused by hepatic cirrhosis.Methods The diagnosis and treatment of 17 cases with PVT caused by hepatic cirrhosis were retrospectively analyzed.Results The total incidence of PVT after devascularization and/or shunt was 18\^68%(17/91).7 cases were diagnosed by color doppler ultrasonography,and 2 cases by CT,2 cases by mesenteric venography,6 cases by surgery exploration.9 cases were cured by thrombolysis,8 cases underwent intestinal resection and Fogarty embolectomy.1 case died.Conclusion Patients with hepatic cirrhosis,especially those who underwent devascularization and/or shunt and had abdominal distension,abdominal pain or diarrhea,should be paid much attention for the occurrence of PVT.Color doppler ultrasonography and CT attribute to the early diagnosis of PVT.Early diagnosis and active thrombolysis may help to prevent the intestinal necrosis.For the patients who suffered from intestinal necrosis,resection of intestine and mesentery should be performed as soon as possible,anticoagulation should be applied simultaneously.