胃Dieulafoy病出血7例临床分析

目的：总结胃Dieulafoy病出血的临床特征及诊治方法。方法：回顾性分析我院收治的7例胃Dieulafoy病出血的临床资料。结果：7例均为男性，平均年龄46岁，病变部位位于贲门下2-6cm。主要表现为突发性周期性的上消化道大出血，入院时血红蛋白平均为48g/L，出血量平均2700ml。7例均行急诊胃镜检查，6例确诊，l例误诊为胃多发性溃疡并出血。2例经内镜治疗止血，4例行胃局部楔形切除，1例行胃大部分切除加血管缝扎。随访3月-6年无再出血。结论：胃Dieulafoy病的主要特征为突发性周期性上消化道大出血，诊断主要依靠急诊胃镜检查，胃楔形切除术可作为首选术式。

Analysis of gastric dieulafoy lesion hemorrhage of 7 cases

Objective:To investigate the clinical characteristic and the diagnosis and treatment procedures of gastric Dieulafoy lesion hemorrhage.Methods: The clinical data of 7 patients with gastric Dieulafoy lesion admitted from February 1997 to April 2003 were analysed retrospectively. Results: The lesions were located in the proximal stomach, about 2 to 6 cm to the cardia. Abrupt, intermittent, ma ssive upper gastrointestinal hemorrhage was the main character. The average Hb was 48 g/L and the hemorrhage volume was about 2 700 ml at the hospital time. All of the 7 patients accepted emergency gastroscopy and the diagnosis was confirmed in 6 patients. 2 patients were cured by endoscopic hemostasis. 4 patients underwent part stomach wedge resectio n and one patient was treated with subtotal gastrectomy plus the lesion vessel suture. All the patients recovered smoothly after the treatment and no rehemorrhage occurred during the 3 months to 6 years following interview.Conclusion:Gastric Dieulafo y lesion displays abrupt, intermittent, massive upper gastrointestinal hemorrhage. Emergency gastroscopy is the main dia gnostic method and part stomach wedge resection is recommended for the first choice of surgical procedure.