手术证实86例小肠出血的病因及诊断方法探讨

目的:探讨小肠出血的病因和诊断方法。方法:收集我院确诊的小肠出血患者共86例,分析其病因及诊断方法。结果:86例小肠出血的患者中,小肠良性肿瘤、憩室、恶性肿瘤、炎性肠病、血管病变分别有25例(29.1%)、20例(23.3%)、16例(18.6%)、16例(18.6%)、9例(10.4%)。小肠ECT检查诊断小肠活动性出血的阳性率、定位诊断的准确率分别为82.4%、70.6%。肠系膜DSA检查对小肠病变的发现率、诊断小肠活动性出血的阳性率、定位、定性诊断的准确率分别为80.9%、59.6%、76.6%、74.5%。肠系检查定位和定性诊断的准确率分别为41.2%、38.2%。结论:小肠肿瘤是小肠出血的第一位原因,ECT诊断小肠活动性出血阳性率高于DSA,DSA、ECT定位诊断价值大,DSA定性诊断价值高于肠系检查。

Study on the Etiology and Diagnostic Methods of 86 Cases With Small Intestinal Hemorrhage Verified by Operation

Objective: To investigate the etiology and diagnostic methods of small intestinal hemorrhage. Methods: Clinical data from 86 patients with small intestinal hemorrhage were collected. The etiology and diagnostic methods were analyzed. Results: Among 86 cases with small intestinal hemorrhage, small intestinal benign tumors, diverticula, malignant tumors, small intestinal inflammation, angiodysplasia accounted for 25 cases (29.1%), 20 cases (23.3%), 16 cases (18.6%),16 cases (18.6%) ,and 9 cases (10.4%) respectively. The positive rate and localization of active small intestinal hemorrhage by ECT were 82.4% and 70.6% respectively. The detection of small intestinal lesions, positive rate of diagnosing active small intestinal hemorrhage, the accurate rate of localization and qualitative diagnosis by digital subtraction angiography (DSA) were 80.9%,59.6%,76.6%,74.5% respectively.The accurate rate of localization and qualitative diagnosing of small intestinal barium meal were 41.2% and 38.2% respectively. Conclusions: Small intestinal tumors are the primary cause of small intestinal hemorrhage. The positive rate of diagnosing active small intestinal hemorrhage by ECT is higher than that by DSA. DSA and ECT have higher value for localization of small intestinal hemorrhage, and DSA has a higher value in diagnosing the quality of small intestinal hemorrhage than that of small intestinal barium meal.