终末期肾病合并下消化道出血

Lower gastrointestinal bleeding in end-stage of renal disease patients

目的探讨终末期肾病合并下消化道出血的病因及特点。方法对北京大学第一医院2000年1月~2012年10月终末期肾病合并下消化道出血14例患者进行分析。结果终末期肾病合并下消化道出血的病变主要位于结肠,主要病因为毛细血管扩张（3例,21.4%）,其他病因还包括肠道粘膜弥漫性病变、溃疡、小血管破裂、克罗恩病及粪性溃疡（各1例）,未明确出血原因者6例。死亡率为21.4%。结论结肠毛细血管扩张是终末期肾病合并下消化道出血的主要病因。

[ Objective ] To appraise the causes and characteristics of lower gastrointestinal bleeding （LGIB） in end-stage of renal disease （ESRD） patients. [ Methods ] An analysis was made from the clinical records of LGIB in ESRD patients in our hospital from Jan 2000 to Oct 2012. [ Results ] The data showed that the main lesions of LGIB in ESRD patients were located in the colon. Patients with ESRD may develop LGIB from a variety of sources, includ- ing telangiectasia （3 cases, 21.4%）, diffuse mucosal lesions, ulcer, Small blood vessels rupture, Crohn＇s disease and Stercoral ulceration. The mortality is 21.4%. [Conclusions] Telangiectasia in colon are the most common cause of LGIB in ESRD patients.