Sakai Y, Hatakeyama K, Shimoda S, Inoue Y, Ota K, Endo K, Muto T
1st Department of Surgery, Niigata University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1552-5.
We have experienced 471 patients with anal bleeding during the past seven years. The Results are as follows: 1. As for the types of disease, incidence of hemorrhoid, colorectal cancer and ulcerative colitis (UC) was high, while that of small intestinal problems was low. 2. In the cases of remarkable bleeding from the lower intestinal tract, massive or acute progressive bleeding was less frequent than expected. 3. Inflammatory diseases were the main causes of massive bleeding. Bleeding by UC was the major indication for urgent operation. In the cases with acute massive hemorrhage, basic complications were often found and the possibility of the diseases of small intestine and blood vessel disorders also should be considered. 4. At the examination of bleeding patients, it is efficient to explore the lower colon and rectum first by colonoscopy or sigmoidoscopy, for most of the bleeding lesions are found in these portions. 5. As for surgical treatment, most of colorectal cancer patients with hemorrhage are able to be operated with wait- and -see management. For UC patients, complete cure operation is possible even if they have high-dose steroid medication.
在过去七年中，我们共接诊了471例肛门出血患者。结果如下：1. 就疾病类型而言，痔疮、结直肠癌和溃疡性结肠炎（UC）的发病率较高，而小肠疾病的发病率较低。2. 在下消化道明显出血的病例中，大量或急性进行性出血的发生率低于预期。3. 炎症性疾病是大量出血的主要原因。UC导致的出血是紧急手术的主要指征。在急性大出血的病例中，常发现基本并发症，还应考虑小肠疾病和血管疾病的可能性。4. 在检查出血患者时，首先通过结肠镜或乙状结肠镜检查低位结肠和直肠是有效的，因为大多数出血病变都位于这些部位。5. 至于手术治疗，大多数出血的结直肠癌患者能够采用观望管理进行手术。对于UC患者，即使他们使用了大剂量的类固醇药物，也有可能进行根治性手术。
