50例小肠出血病因及诊断分析  

Gastrointestinal bleeding of obscure origin一analysis of 50 cases

作　　者：冉志华[1] 沈谋绩[1] 萧树东[1] 

机构地区：[1]上海第二医科大学,上海消化疾病研究所

出　　处：《中华消化杂志》1996年第2期66-68,T000,共4页Chinese Journal of Digestion

摘　　要：对５０例经小肠钡灌、动脉造影、核素造影、小肠镜等单项或多项诊断手段以及手术证实的各种小肠疾病所致消化道出血的病因诊断进行了分析。结果发现３０例小肠肿瘤中良性２１例，恶性９例，占６０％；其中以平滑肌瘤和平滑肌肉瘤为最多见；小肠非特异性炎症、溃疡８例，占１６％；Ｍｅｃｋｅｌ憩室７例，占１４％；小肠毛细血管扩张症３例，克隆病１例，其他１例。４０例患者行小肠钡灌，２８例与手术相符，包括１９例小肠肿瘤，６例Ｍｅｃｋｅｌ憩室和３例小肠非特异性炎症，阳性率达７０％。动脉造影１０例，４例阳性。结果表明，小肠出血以肿瘤为最常见病因，诊断方法以小肠钡灌阳性率为高，尤能显示肿瘤和Ｍｅｃｋｅｌ憩室。结合动脉造影等其他手段，可进一步提高阳性诊断率。Fifty cases of gastrointestinal bleeding of obscure origin from smallbowel were diagnosed by enteroclysis, angiography, radionucleide scanning enteros- copy and conformed by surgery and pathology. The results showed that small bowel tumor, 2l benign and 9 malignant were found in 30 cases(60%), among them leiomyoma(13 cases)and leiomyosarcoma(3 cases). Nonspecific inflammation of ileum was seen in8, Meckel’s diverticulum in 7, angiodysplasia in 3, Crohn’s disease and others in oneeach. Fortv cases were diagnosed by enteroclysis, of whom 28 were confirmed bysurgery and pathological examination. Angiography was done in l0 cases anddiagnosis was correct in 4 of them. It is concluded that neoplasia is the commonestcause of small bowel bleeding and enteroclysis should be considered as one of the mostuseful diagnostic procedures in the detection of small bowel tumors and Meckel’sdiverticulum. A combination of enteroclysis, angiography, radionucleide scanningand/or enteroscopy is helpful in diagnosis of gastrointestinal bleeding of obscure origin.

关 键 词：小肠出血 出血 病因学 诊断 

分 类 号：R574.504[医药卫生—消化系统]