Gheissari A, Rajyaguru V, Kumashiro R, Matsumoto T
Department of Surgery, Hahnemann University Hospital, Philadelphia, Pennsylvania 19102-1192.
Int Surg. 1990 Apr-Jun;75(2):93-5.
Over a six year span, 41 patients with end stage renal disease (ESRD) were treated for 53 episodes of upper and lower gastrointestinal (UGI & LGI) hemorrhage. Thirty-two patients (78%) were diagnosed as having UGI bleeding and nine patients as having LGI bleeding. Mucosal inflammation of the esophagus, stomach and duodenum were the predominant etiologies of UGI bleeding (64%). The predominant cause of LGI hemorrhage was diverticular disease (33%). Angiodysplasias were found in six patients (15%), four with UGI bleeding and two with LGI bleeding. In the UGI hemorrhage group 20% of the bleeding episodes were recurrent and 13% were from multiple sites. There were no recurrent bleeding episodes in the LGI hemorrhage group. We therefore conclude that UGI bleeding is much more common than LGI bleeding in ESRD patients, and that there is a significantly higher tendency for recurrent bleeding episodes and for multiple bleeding sites in the UGI hemorrhage patients. We also note a higher prevalence of angiodysplasias of the upper and lower gastrointestinal tract in ESRD patients.
在六年的时间里，41例终末期肾病（ESRD）患者因上、下消化道（UGI和LGI）出血接受了53次治疗。32例患者（78%）被诊断为UGI出血，9例患者为LGI出血。食管、胃和十二指肠的黏膜炎症是UGI出血的主要病因（64%）。LGI出血的主要原因是憩室病（33%）。6例患者（15%）发现血管发育异常，4例为UGI出血，2例为LGI出血。在UGI出血组中，20%的出血事件为复发性，13%来自多个部位。LGI出血组没有复发性出血事件。因此，我们得出结论，在ESRD患者中，UGI出血比LGI出血更为常见，并且UGI出血患者复发出血事件和多部位出血的倾向明显更高。我们还注意到ESRD患者上、下消化道血管发育异常的患病率较高。
