结肠毛细血管扩张症88例诊治分析

Diagnosis and treatment of colonic telangiectasia (88 cases)

摘要:

探讨结肠毛细血管扩张症的临床特点和诊疗方法。方法 回顾性分析2010年1月－2017年10月该院消化内镜中心结肠镜下诊断结肠毛细血管扩张症的88例患者的临床资料。结果 结肠毛细血管扩张症60岁以上患者占58.0%（51/88），临床上表现为便血占19.3%（17/88），表现为腹泻、腹痛和腹胀等患者占25.0%（22/88），合并结肠息肉占48.9%（43/88），无症状占55.7%（49/88）；病变位于右半结肠占48.9%（43/88），左半结肠占36.4%（32/88），全结肠占14.8%（13/88）。针对便血患者行结肠镜下局部止血5例[其中氩离子血浆凝固术（APC）止血2例，聚桂醇注射及凝血酶止血1例，钛夹钳夹止血2例]，12例予以对症处理。结论 结肠毛细血管扩张症多见于老年患者，大多无症状，少数可表现为消化道出血，病变位于右半结肠多见，无症状者无需治疗，合并出血者可考虑结肠镜下局部止血治疗。

Abstract:

To explore the characteristics and therapeutic methods of colonic telangiectasia. Methods We first analyzed the clinical data of 88 patients with colonic telangiectasia from Jan 2010 to Oct 2017. Results 88 cases were definitely diagnosed as colonic telangiectasia by colonoscopy. Colonic telangiectasia was present in 51 (58.0%) patients over age 60. The clinical symptoms included hematochezia 19.3% (17/88), abdominal pain and diarrhea 25.0% (22/88), combined with colonic polyps 48.9% (43/88), and asymptomatic 55.7% (49/88). The lesion located in the right hemicolon (48.9%) (43/88), the left colon was 36.4% (32/88) and the total colon was 14.8% (13/88). Two of them were treated by argon plasma coagulation (APC), one of them was treated by thrombin, two of them were treated by titanium clip, and others were untreated. Conclusion Most of the colon telangiectasia are found in the elderly, most of them are asymptomatic, and a few can be shown as gastrointestinal bleeding. Most lesions are located in the right hemicolon, and the asymptomatic patients do not need treatment. The patients with bleeding can treated with the local hemostasia therapy under the colonoscopy.