49例小肠出血的临床分析

目的 探讨小肠出血的诊断方法,方法 回顾性分析49例小肠出血的临床资料。结果 肿瘤21例（42.9%),以良性肿瘤多见;感染性疾病12例（24.5%);憩室8例（16.3%);血管畸形6例（12.2%),各种检查的阳性率,核素扫描76.9%,血管造影58.9%,肠系X线25%,术后再出血5例,短肠综合征1例。结论 小肠出血以肿瘤最常见,感染性疾病值得重视。核素扫描憩室的阳性率高,选择性血管造影对血管病变及富含血管的病变有较高的诊断价值,肠系X线对实质性病变及憩室的诊断率较高,剖腹探查结合术中内镜可以提高诊断率。

Clinical study on diagnosis and treatment of small intestinal hemorrhage

Objective To investigate the diagnostic and therapeutic methods of small intestinal hemorrhage.Method Clinical data of forty-nine cases of small intestinal hemorrhage were analyzed retrospectively.Results Small intestinal tumors were found in 21 cases (42.9%),among wtich,most were benign;infectious diseases in 12(24.5%);diverticula's in 8(16.3%);and vascular malformations in 6(12.2%).Radionuclide scanning was positive in 10 out of 13 cases (76.9%).Angiography was performed in 12,7 of them were abnormal (58.3%).Small bowel series made diagnosis in 25% of 36 cases.Postoperative bleeding was found in 5 cases and short bowel syndrome in 1 case.Conclusions Tumors are the most common cause of small bowel bleeding,and acute hemorrhagic nercotizing enteritis and typhoid often cause small bowel massive bleeding.Radionuclide scanning is one of the most useful diagnostic methods for diverticula's.Angiography is a valuable procedure in diagnosis of vascular lesions and malignants.Small bowel series is also helpful in diagnosis of solid lesions and diverticula's. Exploratory surgery coupled with intraoperative endoscopy can be helpful in diagnosis of small bowel bleeding.