Dieulafoy病19例临床分析

目的:探讨Dieulafoy病发病情况、诊断及治疗方法。方法:回顾性分析19例Dieulafoy病的临床表现、诊断、治疗方法及疗效。结果:全部病例均表现突发上消化道大出血。初次胃镜检查确诊12例（63.2%），第2次检查确诊4例（21.1%），术中探查确诊3例（15.8%）；14例经一次内镜下止血成功，1例经二次内镜下止血成功，4例行外科手术止血（包括1例内镜下止血后72h再出血者）。结论:急诊胃镜是诊断Dieulafoy病首选方法；治疗首选内镜下止血，内镜下止血不成功者，应立刻手术治疗。

Clinical analysis of 19 cases of Dieulafoy's disease

Abstract:Objective:To study the clinical features,diagnosis and treatment of Dieulafoy′s disease.Methods:The clinical characteristics,diagnosis,methods of treatment and efficacy of treatment of 19 cases of Dieulafoy′s disease were analyzed retrospectively.Results:All cases presented as abrupt upper gastrointestinal bleeding.12 cases(63.2%) were diagnosed at the first,and 4 cases (21.1%) at the second ecdoscopic examination,and 3 cases(15.8%) were diagnosed at exploratory operation.Hemorrhage stopped successfully after one endoscopic treatment in 14 cases and after 2 endoscopic treatments in 1 case.4 cases were cured by operation(including 1 case with re-bleeding 72 hours after endoscopic treatment).Conclusions:Emergency endosopic examination is the best way to diagnose Dieulafoy′s disease and endoscopic treatment is the method of choice to treat it.If hemorrhage fails to stop after endoscopic treatments,surgical operation should be performed immediately.