文章摘要
王宇.急诊内科老年人下消化道出血病因分析及结肠镜检探讨[J].中国医药导刊,2017,19(10):977-980.
急诊内科老年人下消化道出血病因分析及结肠镜检探讨
Etiological Analysis and Colonoscopy Examination of the Elderly Patients with Acute Lower Gastrointestinal Bleeding in Internal Medicine Emergency
投稿时间:2017-09-20  修订日期:2017-09-20
DOI:
中文关键词: 急诊内科  下消化道出血  老年  结肠镜  病因
英文关键词: Internal medicine emergency  Lower gastrointestinal bleeding  The elderly  Colonoscopy  Etiology
基金项目:国家自然科学基金(项目编号:81500423;项目名称:Th17细胞的分化及调控在黏附侵袭性大肠杆菌LF82加重UC中的作用和机制研究)
作者单位E-mail
王宇 北京市普仁医院急诊科 xiaoyu870727@126.com 
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中文摘要:
      目的:对急诊内科老年人下消化道出血的病因和内镜下表现进行回顾性分析。方法:收集2013年1月至2015年6月我院急诊内科收治的确诊为急性下消化道出血老年患者122例,根据出血量及临床症状分为轻度出血组(59例)、中度出血组(52例)、重度出血组(11例)。所有患者均行结肠镜检以明确病因,并探讨结肠镜的诊疗意义。结果:老年急性下消化道出血的最常见的3个病因依次为结肠癌49例(40.2%)、缺血性肠炎20例(16.4%)及结肠息肉16例(13.1%)。检出出血病灶113处(92.6%),活动性出血病灶91处(74.6%)。重度出血老年患者活动性出血病灶发现率明显高于轻、中度急性下消化道出血(χ2a=18.516,χ2b=4.153,均P<0.05)。在结肠镜下91处活动性出血病灶基本得以妥善治疗。结论:急诊内科老年人下消化道出血的结肠镜检阳性率高,主要病因是结肠癌、缺血性肠炎及结肠息肉,急诊结肠镜对下消化道出血(尤其是中、重度)的早期诊断与治疗具有重要意义。
英文摘要:
      Objective:Retrospectively analyzed the etiology of lower gastrointestinal bleeding in elderly patients and explored the significance of colonoscopy. Methods:122 cases of elderly patients with acute lower gastrointestinal bleeding were collected from January 2013 to June 2015 in our internal medicine emergency. All the elderly patients were divided into mild bleeding group (59 cases), moderate bleeding group (52 cases), and severe bleeding group (11 cases) according to the amount of bleeding and clinical symptoms. All patients underwent colonoscopy to determine the etiology and explore the diagnostic significance of colonoscopy. Results: The three most common causes of the elderly acute lower gastrointestinal bleeding were colon cancer (49 cases, 40.2%), ischemic enteritis (20 cases, 16.4%) and colon polyps (16 cases, 13.1%). 113 cases of bleeding lesions (92.6%) and 91 cases active bleeding lesions (74.6%) were detected in the study. The detection rate of active bleeding lesions in severe bleeding group was higher than mild and moderate bleeding groups (χ2a=18.516, χ2b=4.153, all P<0.05). Conclusion: The main cause of the elderly patients with acute lower gastrointestinal bleeding in internal medicine emergency were colon cancer, ischemic enteritis and colon polyps. Emergency colonoscopy is of great significance for early diagnosis and treatment of lower gastrointestinal bleeding, especially for moderate and severe bleeding.
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