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小肠憩室出血的诊断与治疗:一项回顾性研究。

Diagnosis and treatment of diverticular hemorrhage in small intestine: A retrospective study.

机构信息

Department of Gastrointestinal and Hepatobiliary Surgery, Shenzhen Longhua District Central Hospital, Shenzhen 518110, Guangdong, China.

Department of Gastroenterology, Nansha Hospital, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.

出版信息

Arab J Gastroenterol. 2022 Aug;23(3):144-150. doi: 10.1016/j.ajg.2022.02.002. Epub 2022 Apr 23.

Abstract

BACKGROUND AND STUDY AIMS

Small intestine diverticula are the most common cause of gastrointestinal hemorrhage, but prompt diagnosis remains challenging. Thus, this study aimed to identify strategies for the diagnosis and treatment of diverticular hemorrhage.

PATIENTS AND METHODS

Patients who presented with gastrointestinal tract bleeding to Guangzhou First People's Hospital between 2008 and 2014 were retrospectively examined. Gastrorrhagia and colonic hemorrhage were excluded based on the gastroscopy and colonoscopy findings, and the bleeding sites were in the small intestine. Data regarding patient characteristics, methods of diagnosis, treatment, and prognosis were collected.

RESULTS

Eighty-five patients met the study criteria, and 45 patients were diagnosed with diverticular hemorrhage using double balloon enteroscopy, capsule endoscopy, computed tomography (CT), or digital subtraction angiography (DSA). Among these patients, 10 presented with massive bleeding and hemodynamic instability. All 45 patients underwent surgery and recovered with no complications, and all patients were followed-up for over 3 years, with no cases of recurrent hemorrhage.

CONCLUSION

Diverticular hemorrhage is the most common cause of small intestine bleeding. Double balloon enteroscopy, capsule endoscopy, CT, and DSA are effective methods for diagnosing small intestine diverticular hemorrhage. Surgical resection of the involved region is necessary and may achieve complete cure.

摘要

背景与研究目的

小肠憩室是胃肠道出血的最常见原因,但及时诊断仍具挑战性。因此,本研究旨在确定憩室出血的诊断和治疗策略。

患者与方法

回顾性分析 2008 年至 2014 年期间因胃肠道出血就诊于广州市第一人民医院的患者。根据胃镜和结肠镜检查结果排除胃出血和结肠出血,且出血部位在小肠。收集患者特征、诊断方法、治疗和预后等数据。

结果

85 例患者符合研究标准,其中 45 例经双气囊小肠镜、胶囊内镜、计算机断层扫描(CT)或数字减影血管造影(DSA)诊断为憩室出血。其中 10 例患者出现大出血和血流动力学不稳定。所有 45 例患者均接受手术治疗,无并发症,所有患者均随访 3 年以上,无再出血病例。

结论

憩室出血是小肠出血的最常见原因。双气囊小肠镜、胶囊内镜、CT 和 DSA 是诊断小肠憩室出血的有效方法。受累区域的手术切除是必要的,可实现完全治愈。

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