隐源性消化道出血患者205例临床分析

目的 探讨隐源性消化道出血的病因和不同检查方法的诊断价值.方法 对2008-2012年浙江省绍兴市上虞人民医院隐源性消化道出血205例患者的临床资料进行回顾性分析,选择1种或多种检查方法如内镜（包括胃镜、结肠镜、腹腔镜、小肠镜和胶囊内镜）、气钡双重造影、血管造影检查,对出血发生的部位、病因进行分析.结果 205例患者中病因以良性病变为主,占80.0％（164/205）;病变部位以小肠居多,占74.2％（152/205）.血管病变占38.5％（79/205）;肿瘤为20.0％ （41/205）;炎症病变为11.7％（24/205）;憩室为5.4％（12/205）;小肠息肉为2.4％（5/205）;钩虫为2.4％（5/205）;其他为6.3％（13/205）;不明原因出血为13.7％（28/205）.胶囊内镜检查诊断率为67.1％（94/140）;全腹部CT增强诊断率为30.6％（22/72）;双气囊小肠镜诊断率为63.2％（12/19）;选择性动脉造影诊断率为75.0％（9/12）;气钡造影诊断率为1/7;小肠造影诊断率为1/6.结论 隐源性消化道出血病因以良性病变为主,根据具体情况选择1种或多种检查方法进行诊断.

Clinical analysis of obscure gastrointestinal bleeding

Objective To study the diagnostic method of obscure gastrointestinal bleeding（OGIB） and etiological analysis of OGIB.Methods The clinical data of OGIB were retrospectively analyzed.Endoscopy （including gastroscopy,colonoscopy,laparoscopy,endoscopy and capsule endoscopy）,air barium double contrast radiography,angiography and hemorrhage were analyzed.Results In 205 patients with benign disease etiology,lesions in the intestine were 74.15% （152/205）.Vascular lesions accounted for 38.54% （79/205） ; tumor accounted for 20% （41/205） ; inflammatory lesions was 11.71% （24/205） ; diverticulum accounted for 5.37% （12/205） ; intestinal polyps was 2.44% （5/205） ; hookworm was 2.44% （5/205） ; the other was 6.34% （13/ 205） ; unexplained bleeding was 13.66% （28/205） ; capsule endoscopy diagnosis rate was 67.1% （94/140）.The abdominal CT enhancement diagnosis rate was 30.6% （22/72） ; double-balloon enteroscopy diagnosis rate was 63.2% （12/19） ;selective arteriography diagnosis rate was 75.0% （9/12） ; double contrast radiography diagnosis rate was 14.3% （1/7） ; enterography diagnosis rate was 16.7% （1/6）.Conclusion Obscure gastrointestinal bleeding needs a high success rate of diagnosis.