Schilling M K, Scheurer U, Büchler M W
Klinik für Viszerale- und Transplantationschirurgie, Universität Bern, Inselspital, Schweiz.
Zentralbl Chir. 1998;123(12):1400-4.
Due to its occurence in patients at higher ages with comorbidities, lower gastrointestinal bleeding remains a challenge in terms of diagnostic and therapeutic strategies. In this series (1994-1997, n = 40) the source of bleeding was in the upper gastrointestinal tract in 38% and in the lower gastrointestinal tract in 62%. The source of bleeding could be localized in 58%. Bleeding stopped spontaneously in 40% of all patients but 60% required intervention (54% radiologic or endoscopic intervention, 46% surgery). Segmental resection was the procedure most frequently employed (8/11 patients), 3 patients underwent a subtotal colectomy. In-hospital mortality and surgical morbidity were 0/11 each. Following a staged diagnostic approach and segmental surgical resection, lower gastrointestinal bleeding can be treated with a low morbidity, mortality and a low rebleeding rate.
由于下消化道出血多见于老年合并症患者，在诊断和治疗策略方面仍然是一个挑战。在本系列研究（1994 - 1997年，n = 40）中，38%的出血源在上消化道，62%在下消化道。58%的出血源能够定位。40%的患者出血自行停止，但60%的患者需要干预（54%为放射学或内镜干预，46%为手术）。节段性切除是最常用的手术方式（11例患者中的8例），3例患者接受了结肠次全切除术。住院死亡率和手术并发症发生率均为0/11。采用分阶段诊断方法和节段性手术切除，下消化道出血可以以低发病率、死亡率和低再出血率进行治疗。
