胰源性门静脉高压的研究现状与挑战

倪润; 徐小元; 戴芸

doi:10.12449/JCH260604

胰源性门静脉高压的研究现状与挑战

DOI: 10.12449/JCH260604

北京大学第一医院消化内科，北京 100034

基金项目:

国家科技重大专项 (2025ZD01906300);

国家科技重大专项 (2025ZD01906303)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：倪润负责检索文献，撰写文章；徐小元负责审阅并修订关键性论点；戴芸负责设计文章框架和审校文章。

详细信息

通信作者:
戴芸， daiyun@bjmu.edu.cn （ORCID： 0000-0002-8854-631X）

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出版历程
- 收稿日期: 2026-01-12
- 录用日期: 2026-04-14
- 出版日期: 2026-06-25

Current research status and challenges of pancreatic portal hypertension

Department of Gastroenterology，Peking University First Hospital，Beijing 100034，China

Research funding:

National Science and Technology Major Project (2025ZD01906300);

National Science and Technology Major Project (2025ZD01906303)

More Information

Corresponding author: DAI Yun， daiyun@bjmu.edu.cn （ORCID： 0000-0002-8854-631X）

摘要

摘要: 胰源性门静脉高压（PPH）是一种由胰腺疾病及其并发症导致的区域性门静脉高压。与肝硬化所致门静脉高压不同，PPH病变局限于脾静脉系统，患者肝功能多保持正常。脾静脉阻塞、血液回流障碍是PPH发生的核心机制，孤立性胃底静脉曲张是PPH的特异性表现；对于胰腺疾病患者，需建立PPH早期预警及风险分层管理策略；对PPH患者抗凝治疗、手术及介入治疗的安全性及有效性还需通过高质量研究进一步证实。本文系统梳理了PPH的发病机制、病因分类、临床特征和诊断要点，并对PPH的治疗现状和存在的挑战进行了总结和评述。
- 区域性门静脉高压 /
- 胰腺炎 /
- 脾静脉血栓 /
- 食管和胃静脉曲张
Abstract: Pancreatic portal hypertension （PPH） is a type of regional portal hypertension secondary to pancreatic diseases and their complications. Unlike portal hypertension caused by liver cirrhosis， PPH is confined to the splenic venous system， and most patients tend to have normal liver function. Splenic vein obstruction and impaired blood return are the core mechanisms underlying the development of PPH， and isolated gastric fundal varices represent a characteristic manifestation of PPH. For patients with pancreatic diseases， it is necessary to establish early warning and risk stratification strategies， and high-quality studies are needed to further confirm the safety and efficacy of anticoagulation， surgical approaches， and interventional therapies in patients with PPH. This article systematically reviews the pathogenesis， etiological classification， clinical features， and key diagnostic points of PPH and discusses the current status of PPH treatment and existing challenges.
- Regional Portal Hypertension /
- Pancreatitis /
- Splenic Vein Thrombosis /
- Esophageal and Gastric Varices

HTML全文

注：胰腺疾病及其并发症导致脾静脉血流受阻时，可形成起自胃短静脉的侧支循环，经胃网膜左静脉和胃右静脉引流汇入肠系膜上静脉和门静脉，多表现为孤立性胃底静脉曲张。

图 1 胰源性门静脉高压的侧支循环途径

Figure 1. Collateral circulation pathways in pancreatogenic portal hypertension

下载: 全尺寸图片幻灯片

注： CT，计算机体层成像。

图 2 胰源性门静脉高压诊断流程

Figure 2. Diagnostic algorithm for pancreatogenic portal hypertension

下载: 全尺寸图片幻灯片

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