经手术或病理证实的小肠出血性疾病的临床分析

Clinical analysis of the small intestinal hemorrhage disease confirmed by surgery or pathology

摘要:

目的：分析小肠出血性疾病的临床特征及诊断方法。方法：收集2011年1月至2013年12月间重庆医科大学附属第一医院收治并经病理证实的84例小肠出血性疾病的临床资料，从临床表现、病因、病灶部位、检查方法分别做一探讨。结果：84例小肠出血性疾病中肿瘤占61.90%（52/84），其次为血栓性疾病、小肠憩室、溃疡，分别占11.90%、8.33%、5.95%，其他少见的病因有急性出血坏死性小肠炎、小肠息肉、克罗恩病、肠结核、过敏性紫癜等。出血方式以黑便多见，伴有腹痛、发热、腹部包块、腹泻等。出血部位以空肠、回肠为主。结论：小肠出血性疾病病因以肿瘤为主，临床表现缺乏特异性，诊断困难，治疗棘手，需结合多种检查方法的优缺点及小肠出血病因的特点制定不同的诊断方法。

Abstract:

Objective：To analyze the clinical features and diagnostic methods of small intestinal hemorrhage. Methods：The pathologi－cally confirmed clinical data of 84 patients with small intestinal hemorrhage were collected. All patients were admitted to the First Affiliated Hospital of Chongqing Medical University from January 2011 to December 2013. The manifestation，etiology，lesion and check methods were separately discussed. Results：Tumor was the most frequent cause of small intestinal hemorrhage，accounted for 61.90%（52/84）of all cases，followed by thrombotic diseases，small intestinal diverticulum，ulcer，accounted for 11.90%，8.33%，5.95%，respec－tively. Other rare causes were acute hemorrhagic necrotizing enteritis，intestinal polyps，Crohn’s disease，intestinal tuberculosis，allergic purpura. The clinical manifestation was mainly tarry stool，and accompany symptoms include abdominal pain，fever，abdominal mass，diarrhea，etc. The bleeding lesions were mainly located in jejunum and ileum. Conclusion：Tumor is the major cause of small intesti－nal hemorrhage. It is difficult to diagnose small intestinal hemorrhage. We should combine the various check methods with etiology characteristic of small intestinal bleeding to develop different diagnostic methods.