60例不同病因的小肠出血诊治分析

Analysis of Diagnosis and Treatment of 60 Cases of Small Intestine Bleeding with Different Etiologies

摘要: 目的：分析探讨小肠出血的不同病因、诊断过程及不同治疗方法的预后差别；方法：回顾性分析本院2023年1月~2024年12月我院收治的60例小肠出血的患者，病因明确前均完善全腹部增强CT或小肠CTE，后全部完成小肠镜检查，针对此组小肠出血的病因、影像学阳性率，与小肠镜结果阳性率吻合度，治疗方式及预后进行分析；结果：小肠出血性疾病中小肠溃疡最为多见，占本组病例的31.7%，其次是小肠肿瘤和炎症占本组病例的33.3%，血管性病变占本组病例的15%，Meckel憩室占本组病例的5%，另有15%结果阴性。小肠镜前所有患者均完善了小肠CTE或全腹部增强CT检查，其中小肠炎症、血管性病变及2例憩室影像学均阴性，其余患者均阳性，为小肠镜检查提供了有意义的价值。结论：小肠出血以肿瘤、血管性病变、炎症为多，除小肠镜以外，腹部增强CT及小肠CTE等影像学检查检查有重要价值，治疗方法有内科药物、内镜下微创治疗、外科手术，另外血管介入治疗也有重要价值。

Abstract: Objective: To analyze and discuss the different causes, diagnostic processes, and prognoses of various treatments for small bowel bleeding. Methods: A retrospective analysis was conducted on 60 patients with small bowel bleeding admitted to our hospital from January 2023 to December 2024. Before the causes were determined, all patients underwent full abdominal enhanced CT or small bowel CTE. Subsequently, all patients underwent small bowel endoscopy. The study analyzed the causes of small bowel bleeding, the positive rates of imaging studies, the consistency between the positive rates of imaging studies and small bowel endoscopy results, treatment methods, and prognosis. Results: Among the diseases causing small bowel bleeding, small bowel ulcers were the most common, accounting for 31.7% of the cases. Small bowel tumors and inflammation accounted for 33.3%, vascular lesions for 15%, Meckel’s diverticulum for 5%, and 15% had negative results. All patients underwent small bowel CTE or full abdominal enhanced CT before small bowel endoscopy. Imaging studies for small bowel inflammation, vascular lesions, and two diverticula were negative, while the rest were positive, providing significant value for small bowel endoscopy. Conclusion: Small bowel bleeding is primarily caused by tumors, vascular lesions, and inflammation. In addition to small bowel endoscopy, enhanced abdominal CT and small bowel CTE are of great value. Treatment options include medical drugs, minimally invasive endoscopic treatment, surgical procedures, and vascular interventional therapy.