注水法肠镜在急性活动性下消化道出血诊治中的临床应用

Clinical Application of Water Injection Enteroscopy in Diagnosis and Treatment of Acute Active Lower Gastrointestinal Bleeding

目的探讨注水法肠镜在急性活动性下消化道出血诊断及治疗中的应用。方法收集该院2016年1月-2018年12月间行注水法肠镜诊治的63例急性活动性下消化道出血患者病历资料,并对其肠镜下诊断、治疗及安全性进行回顾分析。结果经注水法肠镜检查,57例急性活动性下消化道出血均查明原因:其中9例为结肠癌伴出血,转为外科手术;30例为息肉出血(47.6%)、9例为血管扩张,畸形破裂出血(14.2%)、6例为结肠腺瘤肠镜下切除后创面出血(9.5%)、3例为服用阿司匹林所致结肠溃疡出血(4.3%),均行内镜下止血治疗,经内镜治疗后痊愈,无并发症发生,治愈率100.0%。结论注水法肠镜适用于急性活动性下消化道出血病因诊断,能对息肉性出血、血管畸形、内镜治疗后创面出血进行病因性治愈。注水法肠镜检查在活动性下消化道出血的诊治中安全可靠,可在医院广泛应用。

Objective To investigate the application of water injection enteroscopy in the diagnosis and treatment of acute active lower gastrointestinal bleeding.Methods The medical records of 63 patients with acute active lower gastrointestinal bleeding diagnosed and treated by water injection enteroscopy between January 2016 and December 2018 were collected,and their colonoscopy diagnosis,treatment and safety were retrospectively analyzed.Results Through water injection enteroscopy,57 cases of acute active lower gastrointestinal bleeding were identified:9 of them were colon cancer with bleeding and switched to surgery;30 were polyp bleeding(47.6%)and 9 cases were vasodilation and rupture bleeding(14.2%),6 cases of colon adenoma wounds after colonoscopy(9.5%),3 cases of aspirin-induced colon ulcer bleeding(4.3%),all received endoscopic hemostasis treatment Healed after endoscopic treatment,no complications occurred,and the cure rate was 100.0%.Conclusion Water injection enteroscopy is suitable for the diagnosis of the etiology of acute active lower gastrointestinal hemorrhage,and it can etiologically cure polyp hemorrhage,vascular malformations,and wound bleeding after endoscopic treatment.Water injection enteroscopy is safe and reliable in the diagnosis and treatment of active lower gastrointestinal bleeding and can be widely used in hospitals.