摘要
目的 :探讨小肠出血的原因、诊断和治疗。方法 :回顾性分析 6 7例经手术及病理证实的小肠出血的临床资料。结果 :小肠出血原因中肿瘤占首位 (2 9/ 6 7) ,良、恶性肿瘤差异不明显 ,其他原因依次为炎性肠病 (15 / 6 7)、小肠憩室 (12 / 6 7)及血管病变 (7/ 6 7)。分别有 18、17和 10例病人经小肠气钡双重造影、选择性肠系膜血管造影及核素扫描确诊 ,18例剖腹探查确诊。全组病人均经手术治疗 ,以肠段切除为主要手术方法。结论 :小肠出血原因肿瘤占首位 ,其次分别为炎性肠病、小肠憩室及血管病变。小肠气钡双重造影、选择性肠系膜血管造影及核素扫描为诊断小肠出血的主要手段 ,剖腹探查对常规检查难以确诊且又高度怀疑小肠出血的病人也是一种主要诊断手段。小肠出血治疗以药物、内镜治疗为首选 ,如效果不佳则行手术治疗 ,主要为包括病变在内的肠段切除。
Objective:To investigate the causes,diagnosis and treatment of small intestinal bleeding.Methods:The Clinical data of 67 cases of small intestinal bleeding confirmed by surgery and pathology was analyzed retrospectively.Results:Tumor was the first cause of small intestinal bleeding(29/67),there was no significant difference between the number of benign and malignant tumor,other causes were inflammatory small intestinal diseases(15/67),small intestinal diverticulum(12/67),and angiodysplasia(7/67).There were 18,17and 10 cases who were diagnosed by double-contrast barium meal,angiography and radionucleide scanning respectively,18 cases were diagnosed by exploratory laparotomy.Most patients were treated by intestinal segmentectomy.Conclusion:Neoplasia is the most common cause of small intestinal bleeding,other causes are inflammatory small intestinal diseases,small intestinal diverticulum and angiodysplasia.A combination of double-contrast barium meal,angiography,radionucleide scanning,exploratory laparotomy and/or enteroscopy is helpful to diagnose small intestinal bleeding.Medical or endoscopic thyrapy is the first choice for treating small intestinal bleeding,surgical procedure,mainly intestinal segmentectomy,is the second choice.
出处
《中国现代普通外科进展》
CAS
2003年第2期114-115,118,共3页
Chinese Journal of Current Advances in General Surgery
关键词
小肠
出血
Intestine,smallHe·morrhage
