急性出血性直肠溃疡综合征15例临床分析  

Acute hemorrhagic rectal ulcer syndrome:A report of 15 patients

作　　者：吴银亚 张卫平[2] 张超杰 陈旭峰[1] Wu Yinya;Zhang Weiping;Zhang Chaojie;Chen Xufeng(Department of Gastroenterology,the 904th Hospital of PLA,Wuxi 214000,China;Department of Proctology,the 904th Hospital of PLA,Wuxi 214000,China)

机构地区：[1]中国人民解放军联勤保障部队第904医院(无锡太湖医院)消化内科,214000 [2]中国人民解放军联勤保障部队第904医院(无锡太湖医院)肛肠科,214000

出　　处：《中华普通外科学文献（电子版）》2020年第6期443-445,共3页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨急性出血性直肠溃疡综合征(AHRUS)的临床特点、治疗及预后。方法收集2013年1月至2019年12月间中国人民解放军联勤保障部队第904医院收治的15例AHRUS患者资料。结果15例中女性12例(80.0%),年龄(66.0±12.6)岁,格拉斯哥昏迷指数(GCS)(9±5)分,血红蛋白(71.6±4.7)g/L,内镜检查溃疡多发性6例,孤立性9例,距离齿状线2~6(4.1±1.0)cm。5例采用钛夹止血成功;5例采用经肛门缝合结扎法,1例复发,再次行缝扎止血成功;5例采用纱布填塞压迫法,其中3例复发,改用缝合结扎法。15例出血得到控制,但有9例终因严重的基础疾病死于多器官功能衰竭。结论AHRUS伴发于危重症,少见但棘手,以局部针对性治疗为主,临床应增强对该病的认识,及时诊断并选择合适治疗手段。Objective To describe the clinical features,treatment and prognosis of the acute hemorrhagic rectal ulcer syndrome(AHRUS).Methods The data of fifteen AHRUS patients admitted to the 904th Hospital of PLA from January 2013 to December 2019 were collected.Results Among the fifteen patients,twelve were female,mean age was(66.0±12.6)years old,GCS(9±5)score,Hb(71.6±4.7)g/L.Endoscopic findings showed solitary(nine cases)or multiple(seven cases)rectal ulcers,a mean of 2-6(4.1±1.0)cm from the dentate line.Five patients had successful hemostasis with endoscopic titanium clips.Five patients had transanal suture ligation,one patient relapsed and the bleeding was stopped by suture again.Five patients were treated with gauze hemostasis with packs,and three recurred cases were stopped bleeding successfully by suture ligation.Permanent haemostasis was achieved in all the cases,but nine patients died of multiple organs failure by correlated serious original diseases.Conclusions AHRUS is associated with critical illness,rare but difficult to deal with.It is necessary to enhance the clinical understanding of the disease,make timely diagnosis and select appropriate treatment.

关 键 词：消化性溃疡出血 急性出血性溃疡综合征 疾病特征 治疗 

分 类 号：R573.1[医药卫生—消化系统]