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目的探讨经肠镜检查确诊的消化道出血的临床经验。方法采用结肠镜进行检查,非急诊肠镜常规口服20%甘露醇250ml,清洁肠道后进行检查,除因新生物致肠腔狭窄不能继续插镜外,均插至回盲部或明确出血部位。急诊肠镜情况允许做适当的肠道清洁。其余不做导泻和灌肠,检查时反复从活检钳道内冲水及吸引肠腔内积血,并缓慢进镜,直到发现出血灶为止。结果本组260例因下消化道出血者行结肠镜检查,明确病病因者有245例。病因:溃疡性结肠炎(溃结)、直肠炎103例,肛裂、痔35例,慢性结肠炎症35例,大肠癌32例,大肠息肉40例,病因不明15例。病灶部位:位于直肠135例,乙状结肠85例,降结肠15例,横结肠10例,升结肠7例,回盲肠2例,肛管疾患6例。结论下消化道出血原因较多,行结肠镜检有助于明确下消化道出血的原因,以提高对消化道出血病因诊断。
Objective To investigate the clinical experience of gastrointestinal bleeding confirmed by colonoscopy. Methods Colonoscopy was performed. Non-emergency colonoscopy was performed on 250% oral mannitol (20%). After cleaning the intestine, it was checked. Except for the stenosis caused by new organism, . Emergency colonoscopy allows for proper bowel cleaning. The rest did not make cathartic and enema, check repeatedly from the biopsy forceps inside the intestine to flush and attract blood, and slowly into the mirror, until the bleeding hemorrhage so far found. Results The group of 260 cases of lower gastrointestinal bleeding colonoscopy, a clear cause of illness were 245 cases. Etiology: ulcerative colitis (ulceration), proctitis in 103 cases, anal fissure, hemorrhoids in 35 cases, 35 cases of chronic colitis, colorectal cancer in 32 cases, 40 cases of colorectal polyps, etiology in 15 cases. Lesions: 135 cases were located in rectum, 85 cases of sigmoid colon, 15 cases of descending colon, 10 cases of transverse colon, 7 cases of ascending colon, 2 cases of ileocecalus and 6 cases of anal canal disease. Conclusions There are many causes of lower gastrointestinal bleeding. Colonoscopy may help to clarify the cause of lower gastrointestinal bleeding and improve the diagnosis of gastrointestinal bleeding.