肝硬化合并Dieulafoy病所致上消化道出血的诊断和治疗

目的]探讨肝硬化患者因Dieulafoy病所致上消化道出血的诊断要点及治疗。方法]收集本院自1998年1月-2006年12月发现的肝硬化合并Dieulafoy病患者16例,分析其诊治特点。结果]16例患者最初均诊断为肝硬化所致的食道或胃底静脉曲张破裂出血、门脉高压性胃粘膜病变出血、溃疡病出血,但由于治疗效果不好,反复经内镜、血管造影检查,最终确诊为Dieulafoy病,后经内镜下止血或血管介入栓塞治疗好转。结论]由于Dieulafoy病的诊断困难,当合并肝硬化时更容易误诊或漏诊,故提高对此病的认识可提高其生存率。

Diagnosis and treatment of upper gastrointestinal bleeding in liver cirrhosis patients complicated with Dieulafoy lesion

Objective] To investigate the diagnosis and trea ment of upper gastrointestinal bleeding in liver cirrhosis patients complicated with Dieulafoy lesion. Methods] A total of 16 cases of cirrhosis patients complicated with Dieulafoy lesion in our hospital were enrolled in this study. Results] These 16 patients were initially diagnosed as variceal bleeding of esophagus or fundus of stomach, gastric mucosa bleeding induced by portal hypertension and gastric ulcer bleeding, but the treatment was ineffective. Finally the diagnosis was confirmed by endoscopy and angiography examination. Therapeutic measures included endoscopic hemostasis and intervention therapy. Conclusions] The diagnosis of Dieulafoy lesion was diffcult. Dieulafoy lesion with cirrhosis was easier to misdiagnosis or missed diagnosis. Therefore enhanced recognition of this disease induced to increase it＇ s survival rate.