肿瘤性下消化道出血

作者报告１９８７～１９９３年外科治疗大、小肠肿瘤共９５７例，多数为慢性少量便血，急性下消化道大出血仅占１．２５％。其中小肠大出血１６％，大肠大出血０．８５％。小肠肿瘤出血的诊断相当困难，肠系膜上动脉造影诊断价值较大，诊断符合率８７．５％。慢性少量便血者应先做定位与定性诊断，而后按照组织学类型与部位等选择适当的手术方式。多数急性大出血可经保守治疗而止血，以后再作进一步处理。少数需行选择性动脉造影、血管加压素动脉滴注或紧急手术探查。

Oncologic Hemorrhage of Lower Gastrointestine

The auther reports 957 cases of malignancies in the small and large intestines,of which,25 cases were located in the small intestine,and 932 cases in the large intestine. There were12 cases developing acute major lower gastrointestinal hemorrhage.4 cases of the massivebleeding were due to malignant small bowel tumours,and 8 cases were caused by malignantlarge bowel tumours.The diagnosis of bleeding owing to small bowel tumors was very difficult,but the arteriography of superior mesenteric artery had great value in the diagnosis.Thediagnostic correspondence rate was 87.5%. Though most patients of acute massive bleedingrespond to medical management and stop bleeding,a few of them have to be performed by selective arteriography or vasopressin arteria infusion,surgical treatment is necessary to all ofthem. For little,intermittent bleeding per anum,it is important to identify the source of bleedand exclude other diseases.