小肠出血68例临床分析

Clinical analysis of 68 cases of small intestine bleeding

目的探讨小肠出血的病因、诊断与治疗。方法回顾性分析2000年1月至2010年6月我院收治的68例小肠出血患者的临床资料。68例小肠出血患者中4例行肠镜下止血治疗；40例行开腹手术；24例行腹腔镜治疗，其中行小肠部分切除术57例，完全腹腔镜下憩室切除7例。结果小肠出血原因主要以肿瘤为首，占48．5％（33／68）；其次为小肠憩室占29．4％（20／68），小肠炎症占14．7％（10／68），血管病变占7．4％（5／68）。所有患者经治疗后均痊愈出院。结论小肠出血的临床表现无特异性，小肠肿瘤、小肠憩室及炎症是其常见原因，术中肠镜检查可确诊小肠出血。外科手术是小肠出血最有效的治疗方法。

Objective To investigate the causes, diagnosis and treatment of small intestine bleeding. Methods Sixty-eight cases of small intestine bleeding from January 2000 to June 2010 were retrospectively analyzed. Among all cases, 4 underwent routine hemostatic treatment under colonoscopy, 40 treated with open surgery and 24 patients with laparoscopic therapy. Among them, 57 cases underwent part resection for some small intestine, completely laparoscopic resection of diverticula was performed in 7 patients. Results Neoplasms was the leading cause of small intestine bleeding, accounting for 48. 5% （33/68） in these patients, followed by small intestine diverticulum accounted for 29.4% （ 20/68 ）, intestinal infective diseases accounted for 14.7% （ 10/68 ） and vascular disease accounted for 7.4% （5/68）. Conclusion The clinical manifestations of small intestinal bleeding showed no specific signs. Neoplasm, intestine diverticulum and intestinal infective diseases are the most common causes of small intestinal bleeding. Small intestinal bleeding can be diagnosed in intraoperative colonoscopy. Surgery is the most effective treatment for small intestinal bleeding.