Nath R L, Sequeira J C, Weitzman A F, Birkett D H, Williams L F
Am J Surg. 1981 Apr;141(4):478-81. doi: 10.1016/0002-9610(81)90143-4.
The management of patients with lower gastrointestinal bleeding requires a systematic approach based on defined diagnostic and therapeutic methods. Although in 80 percent of patients bleeding will stop spontaneously, 25 percent will have rebleeding and 50 percent of those with rebleeding will bleed again. Angiography documents specific bleeding sites but raises questions related to the incidence, site and frequency of bleeding, as well as the necessity of demonstrating extravasation. We reviewed 49 arteriograms performed for lower gastrointestinal bleeding. We conclude from our findings that angiography identifies a presumptive cause of bleeding in 49 percent of patients; angiography identified the site of bleeding in 86 percent of the patients with active bleeding, thus allowing segmental colectomy. We believe that documentation of angiodysplasia in a patient with lower gastrointestinal bleeding is presumptive evidence for the site of bleeding. Angiography is useful and worthwhile in the work-up of patients with lower gastrointestinal bleeding in an attempt to plan localized, definitive resection, and this may lead to a lower mortality rate.
下消化道出血患者的管理需要基于明确的诊断和治疗方法采取系统的方法。尽管80%的患者出血会自行停止，但25%的患者会再次出血，而再次出血的患者中有50%会再次发生出血。血管造影可记录特定的出血部位，但会引发有关出血的发生率、部位和频率以及显示造影剂外渗必要性的问题。我们回顾了49例因下消化道出血而进行的动脉造影。我们从研究结果中得出结论，血管造影在49%的患者中确定了出血的推定原因；血管造影在86%有活动性出血的患者中确定了出血部位，从而能够进行节段性结肠切除术。我们认为，在下消化道出血患者中记录血管发育异常是出血部位的推定证据。血管造影在评估下消化道出血患者以便计划进行局部确定性切除时是有用且值得的，这可能会降低死亡率。
