Clinical Analysis Of Precise Diagnosis And Treatment Of Small Intestinal Hemorrhage

Objective: Small intestine hemorrhage is a relatively rare type of gastrointestinal hemorrhage.Due to the lack of simple and intuitive diagnostic methods,small intestinal hemorrhage is often difficult to diagnose.Retrospective analysis of clinical data of hospitalized patients with small intestinal hemorrhage can help us discover the precise diagnosis and treatment of small intestine hemorrhage,identify early intervention opportunities to improve patient outcomes,save medical resources.Methods: In total,109 patients with small intestinal hemorrhage were included in this retrospective study.Calculating the diagnostic rate of various methods for diagnosis of small intestinal hemorrhage to study their application value.Using logistic regression analysis to identify the risk factors for rebleeding and requiring surgical intervention in patients with small intestinal hemorrhage.Results: Various benign and malignant tumors,inflammatory disease and vascular lesions were the main causes of small intestine hemorrhage,accounting for 40.37%,29.36%,and 16.51%,respectively.The diagnostic rates of abdominal computed tomography,capsule endoscopy(CE),double-balloon enteroscopy(DBE),angiography and surgical exploration for small intestinal hemorrhage lesions were 44.22%,63.04%,89.23%,50.00%,and 91.23% respectively.There was no significant difference between double-balloon enteroscopy and surgical exploration(P>0.05).The diagnostic rate of DBE for Small intestine hemorrhage was higher than that of CE(P<0.05).The blood urea nitrogen/creatinine ratio(BUN/Cr)of jejunum bleeding was higher than that of ileum bleeding.The receiver operating characteristic(ROC)area under curve(AUC)of BUN/Cr to distinguish jejunum bleeding and ileum bleeding was 0.66,and the correct diagnosis index of BUN/Cr is max as the cut-off point was 0.09.The age more than 50,the hemoglobin level before admission less than 70g/L,the albumin level less than 30g/L and dizziness were associated with rebleeding.The independent predictors for rebleeding was the hemoglobin level before admission less than 70g/L and dizziness.Smoking,drinking and abnormal coagulation mechanisms were associated with requiring surgical intervention.The independent predictors for requiring surgical intervention was not found.Conclusions:1.Various benign and malignant tumors,inflammatory disease and vascular lesions were the main causes of small intestine hemorrhage.2.DBE and surgical exploration are effective means of diagnosing small bowel hemorrhage,followed by CE.BUN/Cr could improve the positive rate of small hemorrhage bleeding effectively.3.The independent predictors for rebleeding was the hemoglobin level before admission less than 70g/L and dizziness.Smoking,drinking and abnormal coagulation mechanisms were associated with requiring surgical intervention.