Strate Lisa L
Harvard Medical School, Boston, MA 02115, USA.
Gastroenterol Clin North Am. 2005 Dec;34(4):643-64. doi: 10.1016/j.gtc.2005.08.007.
Lower gastrointestinal bleeding is one of the most common gastrointestinal indications for hospital admission, particularly in the elderly. Diverticulosis accounts for up to 50% of cases, followed by ischemic colitis and anorectal lesions. Though most patients stop bleeding spontaneously and have favorable outcomes, long-term recurrence is a substantial problem for patients with bleeding from diverticulosis and angiodysplasia. The management of LGIB is challenging because of the diverse range of bleeding sources, the large extent of bowel involved, the intermittent nature of bleeding, and the various complicated and often invasive investigative modalities. Advances in endoscopic technology have brought colonoscopy to the forefront of the management of LGIB. However, many questions remained to be answered about its usefulness in routine clinical practice. More randomized controlled trials comparing available diagnostic strategies for LGIB are needed.
下消化道出血是住院最常见的胃肠道指征之一，在老年人中尤为如此。憩室病占病例的比例高达50%，其次是缺血性结肠炎和肛肠病变。尽管大多数患者会自行止血且预后良好，但对于憩室病和血管发育异常出血的患者来说，长期复发是一个严重问题。由于出血来源广泛、累及肠段范围大、出血具有间歇性以及各种复杂且往往具有侵入性的检查方式，下消化道出血的管理具有挑战性。内镜技术的进步使结肠镜检查成为下消化道出血管理的前沿手段。然而，关于其在常规临床实践中的效用仍有许多问题有待解答。需要更多比较现有下消化道出血诊断策略的随机对照试验。
