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目的探讨下消化道出血的病因、临床特征和影像检查。方法下消化道出血患者1567例(男1034例,女533例),分为儿童组131例(8.4%),青年组484例(30.9%),成年组569例(36.3%)和老年组383例(24.4%)。结果经肠镜确诊88.1%(1381/1567),11.9%(186/1567)后经钡灌肠、腹腔动脉造影和放射性核素扫描等,其中75.3%明确了诊断。出血病因仍以大肠癌(26.2%)、溃疡性结肠炎(22.1%)、息肉(18.7%)、结肠炎(9.9%)和痔(9.7%)居多。息肉男性高于女性(P<0.001);结肠癌和痔则女性高于男性(P<0.01;P<0.05);老年女性大肠癌较老年男性高(P<0.01)。老年组病死率较青年及成年组有显著差异(P<0.05;P<0.01)。结论下消化道出血病因诊断分析可以提高救治效果,减低病死率。
Objective To investigate the etiology, clinical features and imaging of lower gastrointestinal bleeding. Methods A total of 1567 patients (1034 males and 533 females) with gastrointestinal bleeding were divided into 131 children (8.4%), 484 youths (30.9%), 569 adults (36.3%) and 383 Example (24.4%). Results After colonoscopy, 88.1% (1381/1567) and 11.9% (186/1567) were diagnosed by barium enema, celiac angiography and radionuclide scanning, of which 75.3% had definite diagnosis. Causes of bleeding were still mostly colon cancer (26.2%), ulcerative colitis (22.1%), polyps (18.7%), colitis (9.9%) and hemorrhoids (9.7%). Polyps were higher in males than females (P <0.001). Colorectal carcinomas and hemorrhoids were higher in males than in males (P <0.01; P <0.05). Older women had more colorectal cancers than in older males (P <0.01). The mortality rate in the elderly group was significantly higher than that in the young and adult groups (P <0.05; P <0.01). Conclusion The diagnosis of lower gastrointestinal bleeding etiology can improve the treatment effect and reduce the case fatality rate.