消化道毛细血管扩张症的临床特征分析

Clinical features of gastrointestinal tract mucosal telangiectasia

目的总结消化道毛细血管扩张症的临床特征。方法对我院2002年1月~2009年8月收治的14例消化道毛细血管扩张症患者的临床资料进行系统的回顾分析,总结其临床特点。结果 14例消化道毛细血管扩张症患者中男10例,女4例,平均发病年龄71.90岁;10例表现为间断黑便或暗红色血便伴有不等程度失血性贫血,其中7例血红蛋白含量〈80 g/L,平均64.43 g/L;出血部位：胃1例、回肠2例、回盲部2例、盲肠3例、结肠9例、直肠1例,多部位者5例。4例无症状的患者未行任何治疗,8例患者在内科保守治疗后出血暂时控制,但均有复发,2例行内镜下氩离子凝固术（argon plasma coagulation,APC）治疗,其中1例在APC治疗后因复发出血行右半结肠切除术。结论毛细血管扩张是老年人消化道出血的常见原因,出血多发于结肠部。内镜检查是其确诊的主要方法 。

Objective To summarize the clinical features of gastrointestinal tract mucosal telangiectasia.Methods The clinical data including initial symptoms or signs,involvement locations,endoscopy findings and treatments were retrospectively analyzed.Results There were 10 male and 4 female patients,with medium age of 71.90 years.Ten of 14 patients suffered from recurrent gastrointestinal bleeding,with a mean HB level of 64.43 g/L.Endoscopy revealed mucosal telangiectases in stomach（1 case）,ileum（2 cases）,ileocecal junction（2 cases）,caecum（3 cases）,colon（9 cases） and rectum（1 case）.Multiple involvements appeared in 5 cases.Bleeding could be controlled in 8 patients after drug treatment.Two patients were treated under endoscopy argon plasma coagulation（APC）,one of them had to surgical intervention because of temporary amelioration of bleeding after APC treatment.Conclusion Gastrointestinal tract mucosal telangiectasia is a common cause of gastrointestinal tract bleeding in aged patients.Bleeding telangiectasias occurrs in the entire gastrointestinal tract,especially in caecum and colon.Endoscopy is a good choice for diagnosis.