急性下消化道大出血患者急诊肠镜诊断效果及其影响因素

目的 分析急性下消化道大出血患者急诊肠镜诊断效果及影响因素.方法 选取凉山彝族自治州第一人民医院2016年5月至2017年5月收治的56例急性下消化道大出血患者, 均行急诊结肠镜检查, 分析急性下消化道大出血病因, 比较不同肠道准备方法、不同出血程度患者急诊肠镜检查完成情况, 依据急诊肠镜检查成功与否分为检查成功组、检查失败组, 比较2组临床资料, 分析影响急诊肠镜检查的影响因素.结果 急性下消化道大出血病因有结肠癌、结肠息肉、结肠憩室等;不同肠道准备方法诱发再出血或出血加重率无明显差异 (P>0.05) , 重度出血组活动性出血病灶发现率高于轻度出血组、中度出血组 (P<0.05) ;急诊肠镜检查成功组女性、年龄>45岁、阑尾切除史、服药期间步行时间短、肠道准备不充分、检查前未服完全部清肠药、肠道解剖结构异常、医师操作不规范比例低于检查失败组 (P<0.05) ;Logistic回归分析结果显示女性、年龄>45岁、肠道准备不充分、肠道解剖结构异常是急性下消化道大出血患者急诊肠镜检查失败的独立危险因素 (P<0.05) .结论急诊肠镜对急性下消化道大出血尤其是中重度出血有重要诊断意义, 女性、年龄>45岁、肠道准备不充分、肠道解剖结构异常是影响其诊断效果的独立危险因素.

Diagnostic Effects and Influence Factors of Emergency Colonoscopy in Patients with Acute Lower Gastrointestinal Massive Hemorrhage

Objective To analyze the diagnostic effects and influence factors of emergency colonoscopy in patients with acute lower gastrointestinal massive hemorrhage. Me thods 56 cases of patients with acute lower gastrointestinal massive hemorrhage treated in our hospital from May 2016 to May 2017 were selected and treated with emergency colonoscopy. The causes of acute lower gastrointestinal massive hemorrhage were analyzed and the emergency colonoscopy completion conditions in patients with different bowel preparation methods and different degrees of bleeding were compared. According to the results of emergency colonoscopy, the patients were divided into the successful test group and the failed test group, and the clinical data of the two groups were compared, and the influencing factors of the emergency colonoscopy were analyzed. Re s ults The causes of acute lower gastrointestinal massive hemorrhage were colon cancer, colonic polyps, colon diverticulum and so on. There was no significant difference in the rebleeding or bleeding aggravation rate of different intestinal preparation methods (P>0.05) , and the detection rate of active bleeding in the severe hemorrhage group was higher than that in the mild hemorrhage group and the moderate hemorrhage group (P <0.05) . In the emergency colonoscopy group, the number of patients in the successful test group, who were females, aged more than 45 years old, with a appendectomy history, a short walking time during the medication, an inadequate intestine preparation, unfinished lustramentum before examination, intestinal anatomical abnormalities and a non-standard physician operation, were lower than those in the failed test group (P<0.05) .Logistic regression analysis showed that being female, aged over 45, inadequate bowel preparation and intestinal anatomical abnormalities were the independent risk factors for emergency colonoscopy failure in patients with acute lower gastrointestinal massive hemorrhage (P<0.05) .Conclus ionsEmergency colonoscopy has important diagnostic significance for acute lower gastrointestinal massive hemorrhage especially the moderate to severe hemorrhage.Female, aged more than 45 years old, inadequate intestinal preparation and intestinal anatomical abnormalities are the independent influencing risk factor for diagnostic effects.