Smith G W
Postgrad Med. 1981 Mar;69(3):36-49. doi: 10.1080/00325481.1981.11715699.
Angiography has greatly improved the precision of diagnosis of massive lower gastrointestinal bleeding in elderly patients. This, in turn, has permitted a more conservative approach, even when operative management becomes necessary. It bears emphasis, however, that hematochezia in elderly patients is usually relatively benign and tends to cease spontaneously. An overly enthusiastic diagnostic or therapeutic course is not warranted, and conservative control of the acute episode, followed by sufficient evaluation to rule out malignancy, is probably all that is necessary. When massive bleeding becomes persistent or recurrent, however, it is clearly life threatening, and a vigorous diagnostic and therapeutic program should be initiated promptly.
血管造影术极大地提高了老年患者大量下消化道出血的诊断准确性。这反过来又允许采取更保守的方法，即使在需要进行手术治疗时也是如此。然而，需要强调的是，老年患者的便血通常相对良性，且往往会自行停止。没有必要采取过于积极的诊断或治疗过程，对急性发作进行保守控制，随后进行充分评估以排除恶性肿瘤，可能就是所需要的一切。然而，当大量出血持续或复发时，显然会危及生命，应立即启动积极的诊断和治疗方案。
