摘要
目的 分析急诊结肠镜检查急性下消化道出血诊治价值。方法 选择2015年2月-2017年2月收治的94例下消化道出血 患者进行回顾性分析,根据检查方式将其分成观察组(56例)和对照组(38例),观察组经急诊结肠镜检查,对照组经 常规结肠镜检查。统计94例患者出血原因,比较两组首次出血检出率,比较两组患者出血量、输血量、耗时、止血 率和住院时间。结果 结肠癌和结肠息肉引发急性下消化道出血概率明显高于其他不明原因(P<0.05),观察组的首 次出血检出率明显高于对照组,差异有统计学意义(P<0.05);观察组患者检查过程中的出血量和输血量明显少于对 照组(P<0.05),观察组检查耗时短于对照组(P<0.05),观察组止血率明显高于对照组且诊治后住院时间短于对照 组,差异有统计学意义(P<0.05)。结论 急诊结肠镜检查能更准确诊断急性下消化道出血患者的病因,首次出血检 出率较高。
Objective To analyze the diagnosis and treatment value of emergency colonoscopy in acute lower gastrointestinal bleeding. Methods A total of 94 patients with lower gastrointestinal bleeding who were treated between February 2015 to February 2017 were retrospectively analyzed. The patients were divided into observation group (56 cases) and control group (38 cases) according to the examination methods. Observation group was given emergency colonoscopy, and control group was given routine colonoscopy. The causes of bleeding in 94 patients were counted. The detection rate of first bleeding was compared between the two groups. The bleeding volume, blood transfusion volume, time consumption, hemostasis rate and hospital stay were compared between the two groups. Results The probability of acute lower gastrointestinal bleeding caused by colon cancer and colon polyps was significantly higher than that of other unexplained causes (P<0.05). The detection rate of first bleeding in observation group was significantly higher than that in control group (P<0.05). The bleeding volume and blood transfusion volume during examination in observation group were significantly lower than those in control group (P<0.05), and the time consumption of examination in observation group was shorter than that in control group (P<0.05), and the hemostasis rate in observation group was significantly higher than that in control group, and the hospital stay after diagnosis and treatment was shorter than that in control group (P<0.05). Conclusion Emergency colonoscopy can more accurately diagnose the cause of patients with acute lower gastrointestinal bleeding, and it has high detection rate of first bleeding
【关键词】急性下消化道出血;急诊结肠镜;诊治价值
【中图分类号】R445.9;R574
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2019.01.022
前言
急性下消化道出血是指包括小肠、直肠和结肠在 内的Treitz韧带以下消化道部位出血,发病率约为 0.02%-0.03%,多发于同时患有其他系统疾病的老年 患者,致死率高达21%[1]。下消化道急性结构复杂, 出血原因多种多样,临床需对患者下消化道出血原因 进行确诊后方可给出对症的治疗方案,因此,及时有 效的早期诊断方法对确定患者的发病原因和后期治疗方案的开展有积极意义。结肠镜能对肠道中的微小 病变和出血点准确辨识,为后续诊断及治疗提供依 据[2]。本研究通过回顾分析94例下消化道出血患者在 采用急性结肠镜和常规结肠镜的诊断情况,来探讨急 性结肠镜在判断急性下消化道出血原因的作用。
罕少疾病杂志
第26卷, 第 1 期
2019年01月
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