肠道血管瘤16例临床分析

CLINICAL ANALYSIS OF 16 CASES WITH INTESTINAL HEMANGIOMA

目的 :探讨肠道血管瘤临床、内镜、选择性肠系膜动脉造影及病理等的特点和临床诊断线索。方法 :对 16例肠道血管瘤进行回顾性临床分析。结果 :87.5 %的病例有肠道出血 ,主要表现为慢性反复的小量出血 ;病程超过一年者有 6 2 .5 %。内镜下以稍隆起红斑状或广基的蓝色或紫色小肿块 ,表面充血、糜烂或有活动性出血 ,93.8%的病灶小于 1cm。DSA的主要表现为造影剂浓集或外渗 ,并可提示多发病灶。病理特点以海绵状血管瘤为主 ,占 5 6 .3% ,18.8%者表现为多发病灶。结论 :肠道血管瘤的临床表现无特异性 ,内镜及选择性肠系膜血管造影检查有助于确诊。可疑病例必须密切随访 ,严重者应手术探查 ,术前重点是确定病灶的多少和范围。为避免误诊、漏诊 ,应遵循一定的临床诊断程序。

Objective: To investigate the clinical, endoscopic, angiography and pathological features, and clinical clues of diagnosis of the intestinal hemangioma. Methods:Restrospective analysis was made in 16 cases with the intestinal hemangioma. Results: 87.5% intestinal hemangiomas expressed intestine hemorrhage. The main features were chronic a little of bleeding respectively. The case course was 62.5% over 1 year. Endoscopic features were a little of swell reythemas or wide-based blue or purble small masses. They surface could be congestion, erosion or active bleeding. 93.8% lesions was lesser than 1cm. The signs of angiography were concentration or exclusion of radiography agent, and it could indicate many lesions. Mainly pathological signs were 56.3% cavernous hemangioma and 18.8% many lesions. Conclusions: No significance of manifestations of intestinal hemangioma. Endoscopy and angiography can help to establish diagnosis. Suspect patients must be followed up ,and operation should be considered if they were severe. It was important to confirm the numbers or ranges of the focus before operation.To avoid missing diagnosis, we must according to the clinical diagnostic procedure of intestinal hemorrhage.