小肠血管畸形合并出血的临床分析

Clinical Analysis on Gastrointestinal Bleeding Caused by Intestinal Vascular Malformation

目的：探讨小肠血管畸形合并出血的诊断和治疗。方法：回顾性分析13例小肠血管畸形合并出血的临床资料。结果：小肠血管畸形合并出血的患者病程长短不一，青壮年发病率高，出血呈突发性、阵发性发作，常无腹部阳性症状和体征；术前血管造影8例，发现病变6例，12例行手术治疗，均经术中内镜探查确诊。结论：术前DSA检查结合术中经造影管注入羡蓝及内镜探查，可准确定位、避免遗漏病灶、显著缩短手术时间；外科手术是治疗小肠血管畸形合并出血的最有效手段。

Objective To investigate the diagnosis and treatment of intestinal vascular malformation（IVMF）. Methods A retrospectively study on the clinical data of 13 eases of IVMF was made. Results The course of IVMF was uncertain; Most of the patients were young; The hemorrhage was paroxysmal and intermittent, which mostly showed no positive symptom and sign. Of 8 examined by anglography, pathological changes were found in 6 eases; 12 cases underwent operations, of them, all cases were confirmed by endoscopy during operation. Conclusion Examined by DSA before operation and methylene blue injection and endoscopy during operation were important, which can orientation exactly, can reduce missed diagnosis, can reduce the operation time remarkably. Surgical operation was the most effective treatment for bleeding of IVMF.