CAJ | 학술논문

目的总结小肠出血的临床特点及诊治体会。方法收集内科收治小肠出血25例资料进行回顾性分析，比较各种检查对判断出血部位的优劣性及治疗效果。结果25例患者中术前行全消化道造影25例，其中1例明确了出血部位(1/25)，小肠镜对小肠占位性病变的确诊率较高(5/20)，胶囊内镜检查确诊率(3/29)，对急性活动性出血可行腹腔动脉造影确诊率很高(20/20)，对手术前不能通过辅助检查明确出血部位的患者，可依靠手术探查联合术中内镜的检查明确出血原因，有较高的检出率(5/5)。结论：对于小肠出血的患者，手术前明确出血部位至关重要，术前腹腔动脉造影有较高的应用价值，特别适用于急性出血、一般情况较差的患者；对于术前辅助检查不能明确出血部位的患者，可通过术中内镜检查明确出血原因，进行相应的治疗。
목적총결소장출혈적림상특점급진치체회。방법수집내과수치소장출혈25례자료진행회고성분석，비교각충검사대판단출혈부위적우렬성급치료효과。결과25례환자중술전행전소화도조영25례，기중1례명학료출혈부위(1/25)，소장경대소장점위성병변적학진솔교고(5/20)，효낭내경검사학진솔(3/29)，대급성활동성출혈가행복강동맥조영학진솔흔고(20/20)，대수술전불능통과보조검사명학출혈부위적환자，가의고수술탐사연합술중내경적검사명학출혈원인，유교고적검출솔(5/5)。결론：대우소장출혈적환자，수술전명학출혈부위지관중요，술전복강동맥조영유교고적응용개치，특별괄용우급성출혈、일반정황교차적환자；대우술전보조검사불능명학출혈부위적환자，가통과술중내경검사명학출혈원인，진행상응적치료。
Objective To summarize the clinical characteristics and diagnosis and treatment experience of gastrointestinal bleeding . Methods Analysis of the col ection cases with gastrointestinal bleeding, and comparison of the advantages and disadvantages of the dif erent kind of inspection to judge the bleeding parts and treatment. Results The bleeding part of one patient was determined by the digestive tract imaging among 25 patients before the surgery (1/25). The enteroscopy has a high rate of diagnosis on the smal intestine space-occupying lesions (5/20). Capsule endoscopy has a diagnosis rate of 3/29. Celiac artery angiography has a higher diagnosis rate of 20/20 to the acute active bleeding cases. The ploration combined with intra-operative endoscopy has a high diagnosis rate (5/5) to the cases whose bleeding parts could not be determined by the auxiliary inspections. Conclusion It is very important to confirm the bleeding parts for the acute active gastrointestinal bleeding patients, and the celiac artery angiography has the valuable application to these cases, especial y to the patients in poor situation. The intra-operative endoscopy can be applied to the patients whose bleeding parts could not be determined by the auxiliary inspections.