不明原因消化道出血的诊断进展

Progress in Diagnosis of Obscure Gastrointestinal Bleeding

消化道出血作为临床上常见的急诊,临床医生首先考虑的是对症处理,待控制出血情况改善后再完善相应的检查,但这会导致一部分出血的原因难以解释。既往对不明原因消化道出血(Obscure gastrointestinal bleeding, OGIB)多使用常规胃镜和结肠镜检查,而常规检查难以准确发现出血部位,诊断难度大,易误诊,同时对于其检查时机难以准确把握,一直是困扰临床医生诊治的一项难题。但随着内镜技术和影像学发展,特别是胶囊内镜、气囊式小肠镜和CT小肠造的运用,对不明原因消化道出血的诊断有了进一步的认识。本文主要通过复习各种检查手段的相关文献资料,为不明原因消化道出血的诊断作一概述。

Gastrointestinal bleeding is as a common clinical emergency.Clinicians first consider the treatment of the disease,and improve the corresponding examination after the improvement of the control of bleeding,but this will lead to a part of the cause of bleeding being difficult to be explained.In the past,conventional gastroscopy and colonoscopy were often used to examine the Obscure gastrointestinal bleeding(OGIB),but it was difficult to find the bleeding site accurately by routine examination,which was difficult to diagnose and easy to be misdiagnosed.At the same time,it was difficult to accurately grasp the timing of the examination.It has always been a difficult problem for clinicians to diagnose and treat.However,with the development of endoscopy and imaging,especially the use of capsule endoscopy,balloon enteroscopy and CT enterostomy,the diagnosis of obscure gastrointestinal bleeding has been further understood.In this paper,the diagnosis of obscure gastrointestinal bleeding cause was summarized by reviewing the relevant literature and materials of various examination methods.