切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 443 -445. doi: 10.3877/cma.j.issn.1674-0793.2020.06.010

所属专题: 经典病例 文献

论著

急性出血性直肠溃疡综合征15例临床分析
吴银亚1, 张卫平2,(), 张超杰2, 陈旭峰1   
  1. 1. 214000 中国人民解放军联勤保障部队第904医院(无锡太湖医院)消化内科
    2. 214000 中国人民解放军联勤保障部队第904医院(无锡太湖医院)肛肠科
  • 收稿日期:2020-01-05 出版日期:2020-12-01
  • 通信作者: 张卫平

Acute hemorrhagic rectal ulcer syndrome: A report of 15 patients

Yinya Wu1, Weiping Zhang2,(), Chaojie Zhang2, Xufeng Chen1   

  1. 1. Department of Gastroenterology, the 904th Hospital of PLA, Wuxi 214000, China
    2. Department of Proctology, the 904th Hospital of PLA, Wuxi 214000, China
  • Received:2020-01-05 Published:2020-12-01
  • Corresponding author: Weiping Zhang
  • About author:
    Corresponding author: Zhang Weiping, Email:
引用本文:

吴银亚, 张卫平, 张超杰, 陈旭峰. 急性出血性直肠溃疡综合征15例临床分析[J/OL]. 中华普通外科学文献(电子版), 2020, 14(06): 443-445.

Yinya Wu, Weiping Zhang, Chaojie Zhang, Xufeng Chen. Acute hemorrhagic rectal ulcer syndrome: A report of 15 patients[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(06): 443-445.

目的

探讨急性出血性直肠溃疡综合征(AHRUS)的临床特点、治疗及预后。

方法

收集2013年1月至2019年12月间中国人民解放军联勤保障部队第904医院收治的15例AHRUS患者资料。

结果

15例中女性12例(80.0%),年龄(66.0±12.6)岁,格拉斯哥昏迷指数(GCS)(9±5)分,血红蛋白(71.6±4.7)g/L,内镜检查溃疡多发性6例,孤立性9例,距离齿状线2~6(4.1±1.0)cm。5例采用钛夹止血成功;5例采用经肛门缝合结扎法,1例复发,再次行缝扎止血成功;5例采用纱布填塞压迫法,其中3例复发,改用缝合结扎法。15例出血得到控制,但有9例终因严重的基础疾病死于多器官功能衰竭。

结论

AHRUS伴发于危重症,少见但棘手,以局部针对性治疗为主,临床应增强对该病的认识,及时诊断并选择合适治疗手段。

Objective

To describe the clinical features, treatment and prognosis of the acute hemorrhagic rectal ulcer syndrome (AHRUS).

Methods

The data of fifteen AHRUS patients admitted to the 904th Hospital of PLA from January 2013 to December 2019 were collected.

Results

Among the fifteen patients, twelve were female, mean age was (66.0±12.6) years old, GCS (9±5) score, Hb (71.6±4.7) g/L.Endoscopic findings showed solitary (nine cases) or multiple (seven cases) rectal ulcers, a mean of 2-6 (4.1±1.0) cm from the dentate line. Five patients had successful hemostasis with endoscopic titanium clips. Five patients had transanal suture ligation, one patient relapsed and the bleeding was stopped by suture again. Five patients were treated with gauze hemostasis with packs, and three recurred cases were stopped bleeding successfully by suture ligation. Permanent haemostasis was achieved in all the cases, but nine patients died of multiple organs failure by correlated serious original diseases.

Conclusions

AHRUS is associated with critical illness, rare but difficult to deal with. It is necessary to enhance the clinical understanding of the disease, make timely diagnosis and select appropriate treatment.

表1 15例急性出血性直肠溃疡综合征患者临床特点
[1]
Tseng CA, Chen LT, Tsai KB, et al. Acute hemorrhagic rectal ulcer syndrome: A new clinical entity? Report of 19 cases and review of the literature[J]. Dis Colon Rectum, 2004, 47(6): 895-903.
[2]
Delancy H, Hitch WS. Solitary rectal ulcer a cause of life-threatening hemorrhage[J]. Surgery, 1974, 76(5): 830-832.
[3]
Maneerattanaporn M, Pongpaibul A, Pongprasobchai S, et al. Acute hemorrhagic rectal ulcer syndrome: the first case series from Thailand[J]. J Med Assoc Thai, 2012, 95 (Suppl 2): S48-S55.
[4]
陆晓娟, 王晓伟, 李恕军, 等. 急性出血性直肠溃疡综合征6例临床分析[J]. 胃肠病学和肝病学杂志, 2012, 21(9): 802-804.
[5]
Komai T, Omata F, Shiratori Y, et al. Risk factors for acute hemorrhagic rectal ulcer syndrome and its prognosis: A density case-control study[J]. Gastroenterol Res Pract, 2018, 2018: 8179890.
[6]
Matsumoto T, Inokuma T. Clinical course and rebleeding predictors of acute haemorrhagic rectal ulcer: 5-year experience and review of the literature[J]. Colorectal Dis, 2013, 15(7): 878-884.
[7]
Motomura Y, Akahoshi K, Matsui N, et al. Clinical and endoscopic characteristics of acute haemorrhagic rectal ulcer, and endoscopic haemostatic treatment: A retrospective study of 95 patients[J]. Colorectal Dis, 2010, 12(10 Online): e320-e325.
[8]
Prasad JK, Thomson PD, Feller I. Gastrointestinal haemorrhage in burn patients[J]. Burns Incl Therm Inj, 1987, 13(3): 194-197.
[9]
Jung JH, Kim JW, Lee HW, et al. Acute hemorrhagic rectal ulcer syndrome: comparison with non-hemorrhagic rectal ulcer lower gastrointestinal bleeding[J]. J Dig Dis, 2017, 18(9): 521-528.
[10]
Kawabata H, Yamaguchi K, Kawakatsu Y, et al. Experience of manual compression hemostasis under endoscopic observation for acute hemorrhagic rectal ulcer[J]. Gastroenterol Res, 2019, 12(2): 107-110.
[11]
Nishimura N, Mizuno M, Shimodate Y, et al. Risk factors for recurrent bleeding from acute hemorrhagic rectal ulcer[J]. Scand J Gastroenterol, 2018, 53(7): 831-834.
[1] 史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志(电子版), 2024, 21(08): 778-784.
[2] 曹琮沅, 黄烁金, 何倩婷, 王安训. 平阳霉素复合剂治疗口腔颌面部脉管畸形的有效性和安全性[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 368-374.
[3] 易柏成, 李旭光, 王容容, 王新璇. 数字化3D打印导板应用于上前牙钙化根管治疗2例[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 385-390.
[4] 严华悦, 刘子祥, 周少波. 磷酸烯醇式丙酮酸羧激酶-1在恶性肿瘤中的研究进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 452-456.
[5] 高俊颖, 张海洲, 区泓乐, 孙强. FOLFOX-HAIC 为基础的肝细胞癌辅助转化治疗的应用进展[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 457-463.
[6] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[7] 陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[8] 刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[9] 刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[10] 石海波, 赵旭东, 王聪, 曲巍. 气肿性肾盂肾炎、气肿性膀胱炎并脓毒性休克一例报道并文献复习[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 644-647.
[11] 林逸, 钟文龙, 李锴文, 何旺, 林天歆. 广东省医学会泌尿外科疑难病例多学科会诊(第15期)——转移性膀胱癌的综合治疗[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 648-652.
[12] 王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[13] 崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
[14] 张平骥, 徐钰, 李天水, 庞文翼, 符师宁, 张梦圆. 重症患者镇静治疗现状及期望的调查研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 562-567.
[15] 王昌前, 林婷婷, 宁雨露, 王颖杰, 谭文勇. 光免疫治疗在肿瘤领域的临床应用新进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 575-583.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?