儿童消化道出血的围手术期管理

Perioperative management of gastrointestinal bleeding in children

消化道出血是儿科常见疾病,按出血部位不同可分为上消化道出血和下消化道出血。消化内镜是诊断消化道出血的重要手段,内镜检查的时间越早,出血病因的检出率越高,因此在血流动力学稳定的情况下,需尽快完善消化内镜检查。当血流动力学不稳定时,应积极液体复苏,并倡导限制性输血策略。充分的肠道准备对于结肠镜、小肠镜及胶囊内镜的质量非常重要。文章对儿童消化道出血的围手术期管理进行归纳总结,并着重阐述肠道准备的注意事项。

Gastrointestinal bleeding is a common disease in children,which can be divided into upper gastrointestinal bleeding and lower gastrointestinal bleeding according to the location of bleeding.Digestive endoscopy is an important approach to diagnosing the cause of gastrointestinal bleeding.The earlier the endoscopy is conducted,the higher the diagnostic rateis.Therefore,when the hemodynamics is stable,digestive endoscopy should be performed as soon as possible.When hemodynamics is unstable,fluid resuscitation should be activated and restrictive transfusion strategy should be adopted.Adequate bowel preparation is important for the quality of colonoscopy,enteroscopy,and capsule endoscopy.In this review,we summarize the perioperative management of gastrointestinal bleeding in children,and focuses on bowel preparation.