Colacchio T A, Forde K A, Patsos T J, Nunez D
Am J Surg. 1982 May;143(5):607-10. doi: 10.1016/0002-9610(82)90175-1.
We analyzed 178 patients admitted with a diagnosis of lower gastrointestinal hemorrhage from 1970 to 1979. Fifty-four percent had a subsequent or previous episode of bleeding and 78 percent required transfusions. One hundred eighteen patients had rigid sigmoidoscopy, with positive findings in 10 (8.5 percent); 98 underwent angiography, with positive findings in 41 percent; and 58 underwent colonoscopy, with positive findings in 48 percent. Comparison of these tests when the patient had active bleeding revealed the rates of positive findings for angiography and colonoscopy to be 42 and 85 percent, respectively. Sixty-five patients underwent operation and 16 eventually died, for a mortality rate of 25 percent. There was a higher percentage of deaths among patients with nondirected than in those with directed operations (32 versus 22 percent). Patients with lower gastrointestinal bleeding should undergo aggressive diagnostic evaluation utilizing sigmoidoscopy, angiography, and colonoscopy to increase the number of directed operations and decrease mortality and operative morbidity.
我们分析了1970年至1979年期间收治的178例诊断为下消化道出血的患者。54%的患者有后续或既往出血发作，78%的患者需要输血。118例患者接受了硬式乙状结肠镜检查，10例（8.5%）有阳性发现；98例接受了血管造影，41%有阳性发现；58例接受了结肠镜检查，48%有阳性发现。当患者有活动性出血时，对这些检查进行比较发现，血管造影和结肠镜检查的阳性率分别为42%和85%。65例患者接受了手术，16例最终死亡，死亡率为25%。非定向手术患者的死亡百分比高于定向手术患者（32%对22%）。下消化道出血患者应积极进行诊断评估，采用乙状结肠镜检查、血管造影和结肠镜检查，以增加定向手术的数量，降低死亡率和手术发病率。
