中国消化道Dieulafoy病5145例回顾性文献分析  

Retrospective analysis of literatures about 5 145 cases of gastrointestinal Dieulafoy lesion in China

作　　者：汪兴伟[1] 张世荣[1] 陈志惠[1] 沈小春[1] 崔红利[1] 颜綦先[1] 兰春慧[1] 王军[1] 陈东风[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所消化科,重庆400042

出　　处：《中华消化杂志》2017年第7期462-465,共4页Chinese Journal of Digestion

摘　　要：目的探讨中国消化道Dieulafoy病的临床特征、治疗方法和预后。方法以＂Dieulafoy病＂为检索词在中文文献数据库（包括中国知网、维普网、万方数据库、中国生物医学文献数据库）中检索1998年1月至2016年10月中国Dieulafoy病相关报道文献，纳入515篇文献，共5 145例Dieulafoy病患者，总结该病患者的性别、年龄、地域分布、发病部位、治疗方法和预后情况。结果5 145例Dieulafoy病患者中男性3 959例，女性1 186例，男女比为3.34∶1。年龄3～95岁，平均年龄51岁。发病部位以胃部最多（88.82%，4 570/5 145），其次为小肠（8.28%，426/5 145）。胃部以胃体、胃底、贲门为主，小肠以十二指肠为主。临床以突发呕血、黑便或便血为主要表现。治疗方法以内镜下治疗（72.56%，3 733/5 145）为主，其次为手术治疗（25.27%，1 300/5 145）。5 145例Dieulafoy病患者治愈5 099例（99.11%），死亡46例（0.89%）。三级医院内镜下治疗、介入治疗、首次内镜下治疗时间〈24 h者所占比例均高于三级以下医院（P均〈0.01）。三级医院治愈率（99.22%，3 674/3 703）高于三级以下医院（98.54%，1 421/1 442）（χ2＝0.89，P〈0.05），而病死率低于三级以下医院（P〈0.05）。结论中国Dieulafoy病发病率男性高于女性，任何年龄均可发生，发病部位以胃和十二指肠为主，内镜下治疗和手术是主要的治疗方法并且预后良好。Objective To explore the clinical characters, treatment and prognosis of gastrointestinal Dieulafoy lesion in China. Methods Dieulafoy was used as search term, the literatures about Chinese patients with Dieulafoy lesions from January 1998 to October 2016 were retrieved in the Chinese literature library including China National Knowledge Inlrastructure, VIP network, Wanfang database and China Biology Medicine disc, and a total of 515 literatures, 5 145 patients were enrolled and analyzed. The gender, age, geographical distribution, location of the lesion, treatment and prognosis of the disease were summarized. Results Among the 5 145 patients （male 3 959, female 1 186） with Dieulafoy disease, the ratio of male to female was 3.34： 1.00. The age was from 3 to 95 years, and mean age was 51 years. The lesion location was mainly in stomach （88. 82%,4 570/5 145） and second was small intestine （8. 28%, 426/5 145）. In stomach, the lesions were mainly located in gastric corpus, fundus and cardia. The small intestinal Dieulafoy lesions were mainly located in duodenum. The main manifests were sudden hematemesis, melena, and hematochezia. The treatments mainly was endoscopic treatment （72. 56%, 3 733/5 145）, and second was surgery （25.27%,1 300/5 145）. Among the5 145 patients withDieulafoy disease, 5 099 patients （99. 11%） were cured and 46 patients （0. 89%） died. The proportions of endoscopic treatment, interventional therapy and first endoscopic treatment within 24 hours in tertiary hospitals were all higher than those of nontertiary （all P〈0. 01）. The cure rate of tertiary hospitals （99.22% ,3 674/3 793） was significantly higher than that of nontertiary hosptials （98.54% ,1 421/1 442） （x^2 =0.89, P〈0.05） and the mortality was significantly lower than that of nontertiary hospitals （P〈 0.05）. Conclusions The male is more susceptible to Dieulafoy lesion which occurred at any age than the female in China. The predilection sites of Dieulafoy lesion were stomach and duoden

关 键 词：DIEULAFOY病 中国 临床病例 文献 胃肠道 

分 类 号：R57[医药卫生—消化系统]