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急诊下消化道大出血诊断与治疗

Under the emergency diagnosis and treatment of digestive tract hemorrhage
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摘要 目的 探讨急诊下消化道大出血的诊断与治疗。方法 自2014年10月~2015年10月期间,选择我院急诊科收治的急诊下消化道大出血病例38例进行回顾性分析研究,比较患者入院时临床表现及入院后给予的辅助检查及选择处理方法等情况,并统计与分析不同病例的不同转归情况。结果 38例急诊下消化道大出血病例中,最后确诊为直肠癌8例,内痔出血6例,结肠癌4例,小肠憩室炎3例,小肠平滑肌瘤2例,肠息肉大出血3例,肠道锐器伤2例,溃疡性结肠炎2例,急性溃疡肠穿孔2例,肠道手术术后出血2例,急性肠套叠2例,坏死性小肠结肠炎1例,血管畸形1例,主要辅助检查为内窥镜检查、核素扫描,选择性血管造影等辅助诊断技术为主要的辅助诊断技术,处理方法有一般急救措施及补充血容量,止血治疗,手术治疗等,38例患者中;治疗效果显著者31例,有效者4例,无效者2例,死亡1例。结论 急诊下消化道大出血原因多种多样,处理方法也各有异同,内窥镜及核素扫描等辅助诊断技术再快速确诊疾病方面具有非常重要的作用,同时给予及时的补充血容量、急诊手术止血等急诊处理对于减低疾病风险等方面极为重要。 Objective To investigate the diagnosis and treatment of acute hemorrhage of digestive tract in emergency department. Methods from October 2014 to October 2015,38 cases of large hemorrhage of digestive tract in our hospital emergency department were retrospectively analyzed. The clinical manifestations of patients were compared with the clinical manifestations and the choice of treatment methods and other conditions. Results 38 cases of acute lower gastrointestinal bleeding cases,finally diagnosed as rectal cancer in 8 cases,6 cases of hemorrhoids bleeding,4 cases of colon cancer,3 cases of small intestinal diverticulitis,2 cases of leiomyoma of the small intestine,intestinal polyps of 3 cases of hemorrhage,2 cases of intestinal injury,2 cases of ulcerative colitis,2 cases acute ulcer perforation,intestinal operation postoperative hemorrhage in 2 cases,2 cases of acute intussusception,1 cases of necrotizing enterocolitis,vascular malformation in 1cases,mainly for the auxiliary examination,endoscopy radionuclide scan,selective angiography diagnosis technology for diagnosis technology,processing method of general first- aid measures and supplement the blood volume,hemostatic treatment,operation treatment,38 patients; 31 cases of obvious curative effect,4 cases effective,2 cases invalid,1 cases of death. Conclusion: emergency treatment of large hem-orrhage in the emergency department of a variety of methods are also different,endoscopic and radionuclide scanning and other auxiliary diagnostic techniques to diagnose the disease is very important role,but it is important to give timely supplementary blood volume,emergency surgery and other emergency treatment to reduce the risk of diseases,etc..
作者 黄燕
出处 《结直肠肛门外科》 2016年第S1期32-33,共2页 Journal of Colorectal & Anal Surgery
关键词 急诊 下消化道大出血 诊断与治疗 Emergency department the large hemorrhage of lower digestive tract diagnosis and treatment
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