食管
静脉曲张
治疗
形成
报道
文献
复习
苏园园
7 邵占涛,王园园,李颖,等.2013-2014 年北京市顺义区感染性腹泻病原菌监测分析 J.实 用预防医学,2015,22(10):1244-1246.DOI:10.3969/j.issn.1006-3110.2015.010.030.8 石挺丽,黄建华,李秀芬,等.2014-2015 年广州地区腹泻患儿和健康儿童致泻性大肠埃希菌流行特征及耐药分析J.中华疾病控制杂志,2016,20(4):329-332.DOI:10.16462/ki.zhjbkz.2016.04.002.Shi TL,Huang JH,Li XF,et al.Epidemiological characterization and antimicrobial resistance of diarrhea Escherichia coli from acute diarrheal and healthy children in Guangzhou City,2014-2015 J.Chin J Dis Control Prev,2016,20(4):329-332.DOI:10.16462/ki.zhjbkz.2016.04.002.9 靳晓红,崔玉玲,李彦,等.济南地区 3 种致泻性大肠埃希菌的血清型分析J.临床检验杂志,2013,31(4):319.10 郑恩惠,林杰,李曲文,等.2016 年福建省永安及南平监测点五种致泻性大肠埃希菌监测分析J.实验与检验医学,2017,35(5):671-672,676.DOI:10.3969/j.issn.1674-1129.2017.05.011.11 叶郁辉,李苑,牛姬飞,等.福田区致泻性大肠埃希菌感染的流行病学分析J.热带医学杂志,2011,11(7):811-813.Ye YH,Li Y,Niu JF,et al.An epidemiology analysis of diarrheo-genic Escherichia coli in Futian district J.J Trop Med,2011,11(7):811-813.12 赵建玉,周倩倩,王玫,等.2016 与 2019 年成人致泻性大肠埃希菌食源性腹泻临床流行病学特征研究 J.中华检验医学杂志,2021,44(4):310-316.DOI:10.3760/114452-20201208-00884.Zhao JY,Zhou QQ,Wang M,et al.Clinical epidemiological charac-teristics of adult diarrhea-induced Escherichia coli foodborne diarrhea in 2016 and 2019 J.Chin J Lab Med,2021,44(4):310-316.DOI:10.3760/114452-20201208-00884.13 曲梅,张新,钱海坤,等.北京地区腹泻病患者致泻性大肠埃希菌感染类型及其流行特征 J.中华流行病学杂志,2014,35(10):1123-1126.DOI:10.3760/cma.j.issn.0254-6450.2014.10.010.Qu M,Zhang X,Qian HK,et al.Study on the genotype and epidem-ic characteristics of diarrheagenic Escherichia coli isolated from diar-rheal patients in Beijing J.Chin J Epidemiol,2014,35(10):1123-1126.DOI:10.3760/cma.j.issn.0254-6450.2014.10.010.14 陈爱平,吴旭辰,熊美琴,等.实时荧光 PCR 检测肠致泻性大肠杆菌在腹泻人群中的分布 J.海峡预防医学杂志,2012,18(2):1-3.Chen AP,Wu XC,Xiong MQ,et al.Detection on distribution of di-arrheagenic E.coli in the diarrheal population by RT-PCR J.Strait J Pre Med,2012,18(2):1-3.15 张苗.淄博市食源性疾病中致泻性大肠埃希菌基因分型、溯源研究及耐药性分析D.青岛:青岛大学,2018.Zhang M.Genotyping,tracing and drug resistance study of diarrhege-nic Escherichia coli as foodborne diseases in Zibo D.Qingdao:Qingdao University,2018.16 徐奎.2003-2012 年中国肠出血性大肠杆菌 O157:H7 病原微生物学文献 计 量 学 分 析 J.医 学 理 论 与 实 践,2014,27(4):425-427.Xu K.2003-2012 Chinese intestinal analysis of Escherichia Coli O157:H7 pathogenic microbiology bibliometrics J.J Med Theor&Prac,2014,27(4):425-427.17 Rodas C,Mamani R,Blanco J,et al.Enterotoxins,colonization fac-tors,serotypes and antimicrobial resistance of enterotoxigenic Esche-richia coli(ETEC)strains isolated from hospitalized children with di-arrhea in Bolivia J.Braz J Infect Dis,2011,15(2):132-137.DOI:10.1016/s1413-8670(11)70158-1.doi:10.3969/j.issn.1006-5709.2023.01.010个案报道基金项目:河北省 2019 年度医学科学研究课题(20190260)第一作者简介:苏园园,硕士,研究方向:消化系病。E-mail:908228436 通讯作者:王玉珍,博士,主任医师,研究方向:消化系病。E-mail:wyzhen211 食管胃底静脉曲张内镜治疗后反复无症状急性门静脉血栓形成:1 例报道并文献复习苏园园1,2,王存凯2,白云2,于亭亭2,赵爽2,闫雪梅1,2,王玉珍21.河北医科大学研究生学院,河北 石家庄 050000;2.河北省人民医院消化内科【摘要】急性门静脉血栓(portal vein thrombosis,PVT)是指近期门静脉主干或其分支血栓形成,其临床表现可从无症状到危及生命的肠缺血和梗死出现。本文将报道 1 例因肝硬化合并食管胃底静脉曲张 2 次行内镜治疗,均于术后早期出现无症状大面积 PVT,应用低分子肝素抗凝治疗后血管再通的患者并做相关文献复习。【关键词】内镜下静脉曲张治疗;急性门静脉血栓;无症状;抗凝治疗中图分类号:R57文献标识码:B文章编号:1006-5709(2023)01-0045-03收稿日期:2021-12-27Repeated asymptomatic acute portal vein thrombosis after endoscopic treatment of esophageal and gastric varices:one case report and literature reviewSU Yuanyuan1,2,WANG Cunkai2,BAI Yun2,YU Tingting2,ZHAO Shuang2,YAN Xuemei1,2,WANG Yuzhen21.Graduate School of Hebei Medical University,Shijiazhuang 050000;2.Department of Gastroenterology,Hebei General Hospital,China54胃肠病学和肝病学杂志2023 年 1 月第 32 卷第 1 期Chin J Gastroenterol Hepatol,Jan 2023,Vol.32,No.1【Abstract】Acute portal vein thrombosis(PVT)refers to the recent thrombosis of the main portal vein or its branches,and its clinical manifestations can range from asymptomatic to life-threatening intestinal ischemia and infarction.In this paper,a patient with cirrhosis com-plicated with esophagogastric varices who underwent endoscopic treatment twice and presented asymptomatic large-scale PVT in the early postoperative period and recanalized after anticoagulant therapy with low-molecular weight heparin was reported and relevant literature review was conducted.【Key words】Endoscopic variceal treatment;Acute portal vein thrombosis;Asymptomatic;Anticoagulant therapy门静脉血栓(portal vein thrombosis,PVT)是指门静脉主干(main portal vein,MPV)和(或)门静脉左、右分支发生血栓,伴或不伴肠系膜静脉和脾静脉(splenic vein,SV)血栓形成1,其中食管胃底静脉曲张的镜下治疗(endoscopic variceal treatment,EVT)易造成血管内皮损伤,激活内源性凝血系统,是导致 PVT的原因之一1-2。急性 PVT 是指近期(30 d)门静脉主干或其分支血栓形成,其临床表现可从无症状到危及生命的肠缺血和梗死出现3。本文将报道 1 例因肝硬化合并食管胃底静脉曲张 2 次行内镜治疗,均于术后早期出现无症状大面积 PVT,应用低分子肝素抗凝治疗后血管再通的患者并做相关文献复习。病例患者,男,46 岁,因呕血 24 h 于 2021 年 7 月 24 日入院。患者 24 h 前无明显诱因出现呕血,为鲜红色,总量约 400 ml,伴胸闷、气短,无头晕、心悸等不适,就诊于我院。既往 4 年前被诊断为慢性乙型肝炎,口服恩替卡韦 5 mg,1 次/d,抗病毒治疗 3 个月后症状好转,自行停药,后未予复查及相关治疗,期间无不适症状。余无特殊病史。入院查体:贫血貌,移动性浊音阳性,余查体无异常。实验室检查:HBsAg、HBeAg、抗-HBc 阳性;HBV DNA 定量 2.16105 IU/ml;血常规:WBC 5.78109 L-1,HGB 59.00 g/L,HCT 0.176 L/L,PLT 175.00109 L-1;凝血:PT 13.4 s,PT-A 69.5%,INR 1.15,DDi 4.15 mg/L FEU;生化:ALB 25.5 g/L,TBIL 23.6 mol/L,DBIL 5.3 mol/L,ALT 26.8 U/L,AST 41.0 U/L,ALP 70.3 U/L