出血性结肠血管扩张症的临床特点

Clinical features of hemorrhagic colonic vascular ectasia

目的总结结肠血管扩张症合并出血的临床特点。方法回顾性分析2007年1月至2014年8月于北京友谊医院住院诊断为结肠血管扩张症合并出血患者的病例资料。结果 14例结肠血管扩张症合并出血患者男性4例,女性10例,平均年龄69.1岁。临床表现以反复便血为主,伴不同程度失血性贫血。腹部体格检查多无阳性体征。14例病例均经结肠镜确诊,扩张血管多位于回盲部或右半结肠,也可散在或弥漫分布。对伴有活动性出血的结肠血管扩张予内镜下氩等离子凝固术治疗或钳夹止血,预后良好。结论结肠血管扩张症是老年人复发性下消化道出血的常见病因,临床表现以反复便血为主,结肠镜是确诊的主要方法,对伴活动性出血者可予内镜下氩等离子凝固术或钳夹止血治疗。

Objective To summarize the clinical features of hemorrhagic colonic vascular ectasia. Methods Retrospectively analyze the clinical data of hospitalized patients who were diagnosed as hemorrhagic colonic vascular ectasia in Beijing friendship hospital from January,2007 to August,2014. Results Four male and 10 female patients were included in the study with average age of 69. 1. The patients presented mainly with recurrent overt or occult gastrointestinal bleeding,as well as blood loss anemia. There were almost no positive signs in their abdominal physical examinations. All cases were diagnosed by colonoscopy. Most of the lesions were detected in the cecum or right colon,while some lesions were scattered or diffuse distributed in the colon. The bleeding lesions could be controlled by argon plasma coagulator（ APC）or clamps under endoscopy with good prognosis. Conclusion Colonic vascular ectasia is a common cause of recurrent lower gastrointestinal bleeding in the elderly. The patients presented mainly with recurrent overt or occult gastrointestinal bleeding. Colonoscopy is a good choice for diagnosis. The bleeding lesions can be controlled by APC or clamps under endoscopy.