急性下消化道出血52例临床分析

Clinical analysis of 52 cases of acute lower digestive tract hemorrhage

目的分析急性下消化道出血的临床特征,探讨其诊断和治疗措施。方法对52例急性下消化道出血病人的临床资料进行回顾性分析。结果 52例经结肠镜检、选择性动脉造影、手术探查及病理检查证实其病因分别为:结肠肿瘤15例(28.8%),小肠肿瘤9例(17.3%),肠道血管病变9例(17.3%),直肠癌8例(15.4%),息肉5例(9.6%),炎症性肠病4例(7.7%),原因不明2例(3.8%)。其中43例行手术治疗,9例行非手术治疗。51例治愈或成功止血,1例死于手术后多器官功能衰竭(multiple organ failure,MOF)。结论急性下消化道出血的大部分病例可通过结肠镜检、选择性动脉造影、手术探查及病理检查明确病因及出血部位,术中肠镜检查有助于确诊;手术切除病灶是最有效的治疗方法。

Objective To study the clinical features of acute lower digestive tract hemorrhage and explore its diagnosis and treatment methods. Methods The clinical data of 52 cases of acute lower digestive tract hemorrhage were analyzed retrospectively. Results Fifty-two patients with acute lower digestive tract hemorrhage were confirmed by endoscopy, selective arteriography, surgical exploration and pathological examination. The causes of acute lower digestive tract hemorrhage included neoplasm of colon （15 cases,28. 8 ~/＇0）, small intestine tumor（9 cases, 17. 3 ~）, vascular pathological changes（9 cases, 17. 3%）, rectal carcinoma（8 cases, 15.4% ）, polyp （5 cases, 9. 6 % ）, inflammatory bowel disease（4 cases,7. 7 %） and other lesions （3. 8 %）. Forty-three cases were treated surgically, and the remaining 9 cases by conservative methods. One patient died from MOF. Conclusion The pathogenicity of most patients with acute lower digestive tract hemorrhage could be confirmed by endoscopy, selec- tive arteriography,operative exploration and pathological examinations. Enteroscopy might conduce to diagnosis during operation and focal resection might be an effective method in patients with massive lower digestive tract hemorrhage.