不明原因消化道出血45例分析

Analysis of 45 cases of obscure gastrointestinal bleeding

目的探讨不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)的病因及胶囊内镜在其诊断方面的应用价值。方法回顾性分析中国医科大学附属第一医院2004年1月-2013年8月45例经胃镜、结肠镜检查未发现出血灶并进一步行胶囊内镜的OGIB患者的临床资料。结果入选的45例OGIB患者中共有42例检出小肠病变,其中单纯小肠血管畸形29例,小肠炎症2例,小肠蛔虫病1例,小肠溃疡1例,小肠息肉1例,十二指肠血管畸形1例,小肠血管畸形伴小肠黏膜下病变2例,小肠血管畸形伴蛔虫病2例,小肠血管畸形伴小肠溃疡、小肠淋巴管扩张1例,小肠血管畸形伴小肠糜烂1例,小肠血管畸形伴小肠憩室、小肠淋巴管扩张1例。OGIB最常见的病因为小肠血管畸形(83.33%,35/42)。结论胶囊内镜在OGIB的病因分析中能提供较直接的线索,对探索其病因及指导临床治疗具有重要意义。

Objective To investigate the etiology of obscure gastrointestinal bleeding （ OGIB） and the value of cap-sule endoscopy in the diagnosis of OGIB .Methods The data of 45 cases of OGIB who were defined no clear hemor-rhage by recepting endoscopy and colonoscopy inspection and furtherly finished capsule endoscopy examination in the First Affiliated Hospital of China Medical University from Jan .2004 to Aug .2013 were analyzed retrospectively .Re-sults Forty-two cases of OGIB patients were proved to have small intestinal lesions , there were 29 cases of small bowel vascular malformations , 2 cases of small bowel inflammation , 1 case of small bowel ascariasis , 1 case of small bowel ul-cer, 1 case of small bowel polyps , 1 case of duodenal vascular malformation , 2 cases of small bowel vascular malforma-tion with small bowel mucosa lesions , 2 cases of small bowel vascular malformation associated with small bowel ascaria -sis, 1 case of small bowel vascular malformation with small bowel ulcer , small bowel lymphangiectasia , 1 case of small bowel vascular malformation with small bowel erosion and 1 case of ileal diverticula with ileal lymphangiectasia .The most common cause of OGIB was small bowel vascular malformations （83.33%, 35/42）.Conclusion Capsule endos-copy can provide more direct clues to discover the cause of OGIB and guide clinical treatment .