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目的 :通过对手术及病理证实的 66例空回肠出血患者进行分析 ,探讨出血的病因诊断。方法 :对 66例空回肠出血患者分别行结肠镜检 ,小肠气钡造影 ,选择性血管造影 ,均经手术及病理证实诊断。结果 :出血原因中 ,肿瘤 2 7例 (40 .9% ) (其良性肿瘤与恶性肿瘤比例相近 ) ,憩室 1 4例 (2 1 .2 % ) ,非特异性炎症 1 0例 (1 5 .1 % ) ,肠结核 4例 (6 .1 % ) ,急性坏死性小肠炎 3例 (4.5 % ) ,肠伤寒 2例(3 % ) ,感染性疾病 1 9例 (2 8.8% ) ,克隆病 2例 (3 % ) ,肠系膜动脉血栓形成 4例 (6 .1 % )。结肠镜检查阳性率 1 0 .6 % (5/ 4 7) ,小肠气钡造影阳性率 1 1 .1 % (1 / 9) ,选择性动脉造影阳性率 40 % (2 / 5)。结论 :本组空回肠出血病因中肿瘤占出血原因首位 ,感染性疾病及憩室占的比例较高。选择性动脉造影对肠系膜动脉病变具有重要诊断价值。但基层医务人员应根据条件选择适合的特殊检查 ,以尽早明确诊断 ,选择正确的治疗方法
Objective: To analyze the etiological diagnosis of 66 cases of ileal empty hemorrhage confirmed by surgery and pathology. Methods: Colonoscopy, small bowel barium angiography and selective angiography were performed on 66 patients with ileal hemorrhage. All of them were diagnosed by operation and pathology. Results: Among the bleeding causes, 27 (40.9%) had tumors (the proportion of benign tumors to malignant tumors was similar), 14 cases (21.2%) of diverticulum, and 10 cases of nonspecific inflammation 4 cases of tuberculosis (6.1%), 3 cases of acute necrotizing enterocolitis (4.5%), 2 cases of typhus (3%), 19 cases of infectious diseases Cases (3%), mesenteric artery thrombosis in 4 cases (6.1%). The positive rate of colonoscopy was 1.06% (5/47). The positive rate of barium gas in small intestine was 11.1% (1/9) and the rate of selective arterial angiography was 40% (2/5). Conclusion: The causes of hemorrhage in patients with ileocecal hemorrhage in this group accounted for the first cause of bleeding, infectious diseases and diverticula accounted for a higher proportion. Selective arterial angiography has important diagnostic value for mesenteric artery disease. However, the grass-roots medical staff should be based on the conditions of choice for the special inspection, as soon as possible to confirm the diagnosis, select the correct treatment