下消化道出血结肠镜检查方法探讨及结果分析  

Research on colonoscopy method of lower intestinal bleeding and results analysis

作　　者：李承恩[1] 欧希龙[2] 贺永军[1] 宋丽华[1] 曹大中[2] 俞谦[2] 俞婷[2] 张有珍[2] 吴自英[2] 

机构地区：[1]句容市人民医院消化科,江苏句容212400 [2]东南大学附属中大医院消化科,江苏南京210009

出　　处：《现代医学》2011年第5期520-523,共4页Modern Medical Journal

摘　　要：目的:研究下消化道出血结肠镜的检查方法及诊断意义。方法:回顾整理667例下消化道出血患者电子结肠镜检查资料,并对数据行卡方检验进行统计学分析。结果:收集下消化道出血患者共667例,其中小出血547例,大出血120例。大出血患者中需要行急诊结肠镜检查43例,非急诊结肠镜检查77例。本组肠镜检查阳性的病变发现率达93.5%,最常见疾病依次为大肠癌、息肉及溃疡性结肠炎,检出率分别占38.5%、20.2%、14.7%,共占检出病例数的73.4%。肠镜检查到达盲肠占77.5%,不能到达盲肠为22.5%,其中因大肠癌引起占17.2%大,肠癌全结肠镜检查率低,检出的病因多。非急诊结肠镜检查到达盲肠、病灶检出、肠道准备均明显优于急诊结肠镜检查(分别为P<0.050、.0010、.001)。结论:电子结肠镜检查是下消化道出血诊断最有效的方法,大多数情况下非急诊结肠镜检查优于急诊结肠镜检查,大多数患者不需要行紧急结肠镜检查。Objective： To study colonoscopy method and diagnosis of lower intestinal bleeding.Methods： Reviewing the 667 cases of patients with electronic colonoscopy method,and using chi-square test to do statistic test.Results： There were 667 patients with lower intestinal bleeding under this group,among which 547 cases were little haemorrhage and 120 cases were massive haemorrhage.Of massive haemorrhage,43 cases needed the emergency colonoscopy and another 77 cases needed non-emergency colonoscopy.The discovery rate of positive lesion of this colonoscopy group was 93.5%.The most common etiology were successively colorectal carcinoma,colorectal polyps,ulcerative colitis,and the detection rate were 38.5%,20.2% and 14.7% respectively.The incidence of colonoscopy which can reach cecum was 77.5%,and those can not reach was 22.5%.The rate of colorectal carcinoma all colonoscopies were very low,only 17.2% was caused by colorectal carcinoma.The incidence of whole colorectal examination in colorectal carcinoma was only 44.7%（115/257）.There were various causes of pathogenese.The non-emergency colonoscopy in arriving cecum,finding disease and cleaning intestines was obviously superior to emergency colonoscopy（P0.05,0.001,0.001 respectively）.Conclusion： The colonoscopy method was the best one to diagnose lower intestinal bleeding.In most cases,the emergency colonoscopy to lower intestinal bleeding patient was inferior to the non-emergency colonoscopy and not necessary to most patients.

关 键 词：结肠镜 下消化道出血 病因 诊断 

分 类 号：R574.62[医药卫生—消化系统]