938例下消化道出血的临床病因分析(1)
DOI：10.3760/cma.j.issn.1671-0282.2014.12.013
基金项目：国家自然科学基金(81001112);广州市科技局珠江科技新星专项项目(2012J2200019)
作者单位： 510080广州， 广东省人民医院广东省医学科学院消化内科
通信作者：沙卫红，Email：wh-sha@163.com
【摘要】目的回顾性分析938例下消化道出血病因。方法收集我院下消化道出血患者938例，接受结肠镜检查以明确病因，并分析不同年龄组间病因构成差异，卡方检验用于组间率的比较。结果902例经结肠镜检查明确病因，总检出率96.16%。主要病因依次为大肠恶性肿瘤(41.26%)、大肠息肉(12.37%)、炎症性肠病(9.59%)、大肠糜烂溃疡性病变(10.34%)、痔疮出血(8.64%)。青年组、中年组、老年组三组间比较，大肠恶性肿瘤(χ2=68.116， df=2， P=0.000)和大肠息肉(χ2=9.101， df=2， P=0.011)的发生率显著增加，炎症性肠病(χ2=62.150， df=2， P=0.000) 和糜烂溃疡性病变(χ2=20.292， df=2， P=0.000 ) 的发生率则显著下降。结论下消化道出血结肠镜检查阳性检出率高，主要病因为大肠恶性肿瘤、大肠息肉、炎症性肠病、糜烂溃疡性病变、痔疮出血。随着年龄增长，炎症性肠病或糜烂溃疡性炎症导致下消化道出血有所下降，大肠恶性肿瘤或息肉有所增加。
, 百拇医药
【关键词】下消化道出血;结肠镜;病因分析;大肠恶性肿瘤;大肠息肉;炎症性肠病;糜烂溃疡性病变;痔疮;青年组;中年组;老年组
Retrospective analysis of colonoscopic characteristics of 938 cases of lower gastrointestinal tract bleeding
Ma Juan，Deng Weiping， Zeng Zhigang， Liu Wanwei，Wang Qiyi，Sha Weihong. Department of Gastroenterology & Hepatology， Guangdong General Hospital (Guangdong Academy of Medical Sciencies)，Guangzhou 510080，China
Corresponding author： Sha Weihong， Email： wh-sha@163.com
, 百拇医药
【Abstract】ObjectiveTo study the etiology， relevant factors and endoscopic characteristics of acute lower gastrointestinal tract hemorrhage.MethodsA total of 938 patients receiving emergency colonoscopy for acute lower gastrointestinal tract hemorrhage were collected to study the etiological profiles. Different causes between young group and elderly group were also recorded.ResultsThe total detectable rate of acute lower gastrointestinal tract hemorrhage in respect of causes was 96.16% (902/938). The five leading causes were colorectal malignancy (41.26%)， erosive colorectal polypus (12.37%)， inflammatory bowel disease (9.59%)， erosive and ulcer colitis(10.34%)and hemorrhoids (8.64%). Compared with youth and middle age patients， the incidence of colorectal malignancy (χ2=68.116， df=2， P=0.000)and colorectal polyps(χ2=9.101， df=2， P=0.011)were significantly increased in elderly patients， while incidence of inflammatory bowel disease (χ2=62.150， df=2， P=0.000) and erosive and ulcer colitis (χ2=20.292， df=2， P=0.000 ) were significantly decreased in those patients.ConclusionsEmergency colonoscopy for diagnosis of acute lower gastrointestinal tract hemorrhage is an important measure. The major manifestation is bleeding resulting from colorectal malignancy， erosive colorectal polypus， inflammatory bowel disease， erosive and ulcer colitis and anal hemorrhoid. Age is associated with the cause of lower gastrointestinal tract bleeding induced by different kinds of lesions at the colorectum., 百拇医药(马娟 邓卫平 曾志刚 刘婉薇 王启仪 沙卫红)
基金项目：国家自然科学基金(81001112);广州市科技局珠江科技新星专项项目(2012J2200019)
作者单位： 510080广州， 广东省人民医院广东省医学科学院消化内科
通信作者：沙卫红，Email：wh-sha@163.com
【摘要】目的回顾性分析938例下消化道出血病因。方法收集我院下消化道出血患者938例，接受结肠镜检查以明确病因，并分析不同年龄组间病因构成差异，卡方检验用于组间率的比较。结果902例经结肠镜检查明确病因，总检出率96.16%。主要病因依次为大肠恶性肿瘤(41.26%)、大肠息肉(12.37%)、炎症性肠病(9.59%)、大肠糜烂溃疡性病变(10.34%)、痔疮出血(8.64%)。青年组、中年组、老年组三组间比较，大肠恶性肿瘤(χ2=68.116， df=2， P=0.000)和大肠息肉(χ2=9.101， df=2， P=0.011)的发生率显著增加，炎症性肠病(χ2=62.150， df=2， P=0.000) 和糜烂溃疡性病变(χ2=20.292， df=2， P=0.000 ) 的发生率则显著下降。结论下消化道出血结肠镜检查阳性检出率高，主要病因为大肠恶性肿瘤、大肠息肉、炎症性肠病、糜烂溃疡性病变、痔疮出血。随着年龄增长，炎症性肠病或糜烂溃疡性炎症导致下消化道出血有所下降，大肠恶性肿瘤或息肉有所增加。
, 百拇医药
【关键词】下消化道出血;结肠镜;病因分析;大肠恶性肿瘤;大肠息肉;炎症性肠病;糜烂溃疡性病变;痔疮;青年组;中年组;老年组
Retrospective analysis of colonoscopic characteristics of 938 cases of lower gastrointestinal tract bleeding
Ma Juan，Deng Weiping， Zeng Zhigang， Liu Wanwei，Wang Qiyi，Sha Weihong. Department of Gastroenterology & Hepatology， Guangdong General Hospital (Guangdong Academy of Medical Sciencies)，Guangzhou 510080，China
Corresponding author： Sha Weihong， Email： wh-sha@163.com
, 百拇医药
【Abstract】ObjectiveTo study the etiology， relevant factors and endoscopic characteristics of acute lower gastrointestinal tract hemorrhage.MethodsA total of 938 patients receiving emergency colonoscopy for acute lower gastrointestinal tract hemorrhage were collected to study the etiological profiles. Different causes between young group and elderly group were also recorded.ResultsThe total detectable rate of acute lower gastrointestinal tract hemorrhage in respect of causes was 96.16% (902/938). The five leading causes were colorectal malignancy (41.26%)， erosive colorectal polypus (12.37%)， inflammatory bowel disease (9.59%)， erosive and ulcer colitis(10.34%)and hemorrhoids (8.64%). Compared with youth and middle age patients， the incidence of colorectal malignancy (χ2=68.116， df=2， P=0.000)and colorectal polyps(χ2=9.101， df=2， P=0.011)were significantly increased in elderly patients， while incidence of inflammatory bowel disease (χ2=62.150， df=2， P=0.000) and erosive and ulcer colitis (χ2=20.292， df=2， P=0.000 ) were significantly decreased in those patients.ConclusionsEmergency colonoscopy for diagnosis of acute lower gastrointestinal tract hemorrhage is an important measure. The major manifestation is bleeding resulting from colorectal malignancy， erosive colorectal polypus， inflammatory bowel disease， erosive and ulcer colitis and anal hemorrhoid. Age is associated with the cause of lower gastrointestinal tract bleeding induced by different kinds of lesions at the colorectum., 百拇医药(马娟 邓卫平 曾志刚 刘婉薇 王启仪 沙卫红)