急诊结肠镜诊治急性下消化道出血188例临床分析  

Analysis of diagnosis and treatment in 188 patients with acute lower gastrointestinal bleeding by colonoscope

作　　者：杨潇 石磊[1] 张殊翌 钱晶瑶 李彦茹 田正刚[1] 李文[1] YANG Xiao;SHI Lei;ZHANG Shuyi;QIAN Jingyao;LI Yanru;TIAN Zhenggang;LI Wen(Endoscopy Center,Tianjin People’s Hospital,Tianjin 300131,China)

机构地区：[1]天津市人民医院内镜中心,天津300131

出　　处：《胃肠病学和肝病学杂志》2021年第12期1376-1381,共6页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的回顾性分析急性下消化道出血的内镜诊治病例,总结对于急性下消化道出血患者的诊治体会。方法收集2018年7月28日至2020年7月28日于天津市人民医院内镜中心进行紧急结肠镜检查的急性下消化道出血患者188例。回顾性分析所有患者的临床资料及内镜下检出的病变,计算出血原因各占的百分比。结果 20.21%的患者未能查明出血原因,缺血性肠炎为首要出血病因,占比15.43%,憩室为次要出血病因,占比14.89%。缺血性肠炎出血的患者中女性居多,憩室出血的患者中男性居多,差异均有统计学意义(P<0.05)。结论部分情况下急诊结肠镜检查并不能查明急性下消化道出血患者的出血原因,但缺血性肠炎、结肠憩室可能是出血的首要原因。缺血性肠炎出血的患者多见于女性,憩室出血的患者多见于男性。Objective To retrospectively analyzed the endoscopic diagnosis and treatment of patients with acute lower gastrointestinal bleeding, and to summarize the experience of diagnosis and treatment of patients with acute lower gastrointestinal bleeding. Methods A total of 188 patients with acute lower gastrointestinal bleeding who admitted to emergency colonoscopy at the Endoscopy Center, Tianjin People’s Hospital from Jul. 28 th, 2018 to Jul. 28 th, 2020 were enrolled. We retrospectively analyzed the clinical data and endoscopic detection of all patients, calculated the percentage of each bleeding causes. Results 20.21% patient’s cause of bleeding was not identified, ischemic enteritis tied for first place, accounting for 15.43%. Colonic diverticulum was the second, which was 14.89%. Female ischemic enteritis patients were more than the males, while male colonic diverticulum patients were more than the females. The differences were statistically significant(P<0.05). Conclusion In some cases emergency colonoscopy could not identify the cause of bleeding in patients with acute lower gastrointestinal hemorrhage, but diverticulum and ischemic enteritis may the primary causes. Females are predominant in ischemic enteritis patients, while males are predominant in colonic diverticulum patients.

关 键 词：消化道出血 结肠镜 结肠憩室 缺血性肠炎 内镜下止血 

分 类 号：R57[医药卫生—消化系统]