成人Meckel憩室致下消化道出血37例诊治分析  

Adult lower gastrointestinal hemorrhage caused by Meckel's diverticulum:A clinical analysis of 37 cases

作　　者：曲凤智 曹成亮[1] 王刚[1] 段鹏羽 孙备[1] 武林枫[1] 李泮泉 

机构地区：[1]哈尔滨医科大学附属第一医院胰胆外科,黑龙江哈尔滨150001

出　　处：《中国实用外科杂志》2017年第10期1176-1178,共3页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.81100314;No.81370565);黑龙江省新世纪优秀人才培养计划(No.1253-NCET-017)

摘　　要：目的分析成人Meckel憩室致下消化道出血的临床特点、诊断及治疗方法。方法回顾性分析2007年1月至2016年1月哈尔滨医科大学附属第一医院收治的37例成年Meckel憩室致下消化道出血病人的临床资料。其中4例行单纯憩室切除术,33例行憩室切除联合小肠部分切除吻合。结果所有病人经手术治疗后消化道出血症状均有效缓解。术后住院时间为11.6(8~15)d,无围手术期死亡及严重并发症发生,病人均痊愈出院。术后病理学检查均确诊为回肠憩室。随访4~111个月,失访8例,获得随访的29例病人一般情况良好,均未再出血。结论 Meckel憩室是成人下消化道出血的罕见病因,临床表现及术前诊断方法缺乏特异性,易误诊、漏诊,手术是其确诊及治疗的惟一有效手段。Objective To summarize and analyze the clinical characteristics, diagnosis and treatment principle of adult lower gastrointestinal bleeding caused by Meckel＇ s diverticulum. Methods The clinical data of 37 cases of adult lower gastrointestinal hemorrhage caused by Meckel＇ s diverticulum admitted from January 2007 to January 2016 in the First Affiliated Hospital of Harbin Medical University were analyzed retrospectively. Single diverticulum resection was performed in four cases, and diverticulum resection combined with partial small intestine resection and anastomosis was performed in thirty-three cases. Results The lower gastrointestinal bleeding of all the patients who performed surgical treatment had been salved effectively. Postoperative hospital stay was 11.6 （8 to 15） day, without death and serious complication, and all the cases were recovered. All the cases were diagnosed Meckel＇ s diverticulum by pathological examination postoperatively. Eight cases lost the follow up, and 29 cases were followed up for 4 to 111 months with good general condition, bad not been bleeding again. Conclusion Meckel＇ s diverticulum is a rare cause of adult lower gastrointestinal bleeding. Clinical manifestations and preoperative diagnosis methods of Meckel＇ s diverticulum are lack of specificity, and therefore it leads to misdiagnosis and missed diagnosis easily. Surgery is the only effective way to its diagnosis and treatment.

关 键 词：MECKEL憩室 下消化道出血 失血性休克 

分 类 号：R6[医药卫生—外科学]