Dieulafoy病致急性消化道大出血16例临床分析

Clinical analysis of acute massive gastrointestinal bleeding caused by Dieulafoy's lesions in 16 patients

目的探讨Dieulafoy病致急性消化道大出血的临床诊断及综合治疗方法。方法回顾性分析16例Dieulafoy病合并消化道大出血患者的临床资料。结果本组16例出血部位为胃体14例,贲门2例,15例胃镜明确诊断患者中7例行胃镜下止血治疗,8例急诊手术,1例经急诊开腹探查止血,均治愈,住院时间(11.2±2.5)d。结论胃镜下止血为Dieulafoy病首选治疗方法,出血量大者应行手术止血。

Objective To explore the diagnosis and treatment of acute massive gastrointestinal bleeding caused by Dieulafoy＇s lesions. Methods The clinical data of 16 patients with acute massive gastrointestinal bleeding caused by Dieulafoy＇s lesions were retrospectively analyzed. Results In 16 cases, gastrointestinal bleeding occurred at the body of stomach in 14 cases, and at the cardia in 2 cases. In 15 cases of bleeding diagnosed by gastroscopy, 7 cases were performed gastroscopic haemostasis and 8 cases were performed emergent surgical haemostasis. One case of obscure bleeding received laparotomy for haemostasis. All 16 cases were cured. The duration of hospitalization was （11.2±2.5） days. Conclusions Gastroscopic haemostasis is the first choice for gastrointestinal bleeding. Surgery is still the most effective method for the patients with massive bleeding.