广州医药 ›› 2017, Vol. 48 ›› Issue (4): 86-88.DOI: 10.3969/j.issn.1000-8535.2017.04.021

• 论著 • 上一篇    下一篇

小肠出血的病因及诊断分析

彭吉祥, 梁顺宇   

  1. 广州市第一人民医院胃肠外科,广州消化疾病中心(广州 510180)
  • 收稿日期:2017-02-20 发布日期:2021-12-01
  • 通讯作者: 彭吉祥,E-mail:shui_yanhan@126.com

Analysis of the etiology and diagnosis of small intestinal hemorrhage

PENG Jixiang, LIANG Shunyu   

  1. Gastrointestinal Surgery,Guangzhou Digestive Disease Center,Guangzhou First People Hospital,Guangzhou 510180,China
  • Received:2017-02-20 Published:2021-12-01

摘要: 目的 探讨小肠出血的诊断策略。方法 回顾性分析我院2010年1月— 2015年6月收治的42例小肠出血病例的诊治经历。结果 42例患者中肿瘤15例(35.7% );血管发育不良和畸形10例(23.8%);炎性肠病9例(21.4%),憩室7例(16.7%),原因不明1例(2.4%)。气钡双重造影阳性率11.8%;B超检查阳性率15%;核素扫描阳性率44.4%;CT检查阳性率46.7%;血管造影阳性率50%,小肠镜检查阳性率58.9%;胶囊内镜阳性率61.5%;术中肠镜检查阳性率88.9%。结论 小肠出血病因多样,检查缺乏特异性;隐性出血者可选择CT或胶囊内镜,结果阳性者进一步可行小肠镜检查或治疗;活动性出血患者选择ECT或DSA,手术探查或术中肠镜是最后选择。

关键词: 小肠出血, 病因, 诊断

Abstract: Objective To investigate the diagnosis of small intestinal haemorrhage. Methods The diagnosis and treatment of 42 cases of small intestinal haemorrhage between January 2010 and June 2015 were analyzed retrospectively. Results Among the patients, small bowel tumors were found in 15 cases,angiodysplasia in 10,inflammation disease in 9,diverticulum in 7 and obscure bleeding in 1 each. Positive rate of diagnostic methods was followed:enteroclysis 11.7%,B-ultrasound 15%, ECT 44.5%,CT 46.7%,DSA 50%, device-assisted enteroscopy 58.9%, capsule endoscopy 61.5%,enteroscope examination during operation 88.9%. Conclusion There are various etiological factors and lack of specificity in small intestinal haemorrhage. Capsule endoscopy or CT should be used first if the patient had occult bleeding, positive patients were suggested to taken enteroscopy. ECT and DSA must be applicable for active bleeding or other positive patients. Operation or enteroscope examination during operation could be the last measure.

Key words: Small intestinal haemorrhage, Etiology, Diagnosis