Bramley P N, Masson J W, McKnight G, Herd K, Fraser A, Park K, Brunt P W, McKinlay A, Sinclair T S, Mowat N A
Gastrointestinal Unit, Aberdeen Royal Infirmary, Forresterhill, Scotland.
Scand J Gastroenterol. 1996 Aug;31(8):764-9. doi: 10.3109/00365529609010349.
Major colonic haemorrhage poses difficult diagnostic and therapeutic problems and, in contrast to upper gastrointestinal bleeding, has no generally accepted plan of management.
We report community-based prospective data accumulated over 2 years (1991-93) on 1602 patients referred to an open-access bleeding unit with suspected gastrointestinal haemorrhage.
Of 278 (17%) admissions with suspected lower GI haemorrhage, 252 were confirmed. Forty-eight per cent were defined as "significant' bleeds, with a decrease in haemoglobin and cardiovascular compromise. Of 102 significant bleeds in subjects more than 60 years old, 29% rebled, and 12.6% required emergency surgery. Diverticular disease (24%) was the commonest diagnosis, with tumours, infective colitis, and inflammatory colitis each at 10%. The overall 30-day mortality for colonic bleeding was 5.1% (13 of 252), with only 1 death occurring in the group less than 60 years old.
This study provides a unique database for the natural history of colonic bleeding and its management within the setting of a specialized bleeding unit.
大肠大出血带来了诊断和治疗难题，并且与上消化道出血不同，目前尚无普遍认可的治疗方案。
我们报告了在两年（1991 - 1993年）间积累的基于社区的前瞻性数据，这些数据来自1602名因疑似胃肠道出血而转诊至开放式出血治疗单元的患者。
在278例（17%）疑似下消化道出血的入院病例中，252例得到确诊。48%被定义为“严重”出血，伴有血红蛋白下降和心血管功能不全。在60岁以上患者的102例严重出血病例中，29%再次出血，12.6%需要急诊手术。憩室病（24%）是最常见的诊断，肿瘤、感染性结肠炎和炎症性结肠炎各占10%。结肠出血的30天总体死亡率为5.1%（252例中有13例），60岁以下组仅1例死亡。
本研究为结肠出血的自然史及其在专业出血治疗单元中的管理提供了一个独特的数据库。
