儿童消化道出血的诊治进展

Progress in diagnosis and treatment of gastrointestinal bleeding in children

消化道出血在儿童较为常见，其出血原因众多，并随年龄变化而不同。大部分消化道出血通过常规内镜和影像学检查可探明原因，对于少部分不明原因消化道出血，尤其是经保守治疗没有明显效果或者反复出血而不明原因者，胃十二指肠镜、电子结肠镜与腹腔镜联合的“一站式”杂交诊治模式具有较高的临床应用价值。内镜止血微创有效，可针对出血原因尚不明确的病变进行取材活检。随着腔镜技术的进步，经脐单孔腹腔镜在小儿消化道出血中的应用逐渐增多，而对紧急情况下不能控制的大出血仍需积极手术探查。

Gastrointestinal bleeding is common in children. The causes of hemorrhage is numer-ous and varies with age. Most of them can be identified by conventional endoscopy and imaging examina-tion. For unexplained bleeding,especially repeated bleeding which failed to conservative therapy,a one-stop hybrid procedure of gastrduodenoscopy,colonoscopy and laparoscopy showed great clinical application value. Endoscopic hematischesis is widely used for minimally invasiveness,effectiveness,and recognition of biopsied lesions. With the progress of laparoscopic technology,single-port transumbilical laparoscopy is increasingly applied in pediatric gastrointestinal bleeding. While surgical exploration is still mandatory for massive hemorrhage in emergency circumstances.