肛瘘术后不明原因反复出血原因探讨
摘要
术后不明原因反复出血是肛瘘术后少见但复杂的并发症之一，通过查找文献、案例报道及临床 经验总结，从中医血热、气虚、血瘀等方面，西医血液系统疾病、肠道疾病及非甾体抗炎药等方面分析出血原因， 为临床医者治疗肛瘘术后不明原因反复出血提供临床诊疗思路。参考
[1] 李兵 . 肛肠手术后直肠出血临床治疗效果探讨
[J]. 世界最新医学信息文摘 , 2016(A0):1.
[2] 詹鹏超 , 李鑫 , 纪坤 , 等 . 介入诊疗血管畸形
致小肠顽固性出血一例 [J]. 中华介入放射学电子杂志 ,
2019,7(3): 259-262.
[3]Brown C, Subramanian V, Wilcox C M，et al.
Somatostatin ana-logues in the treatment of recurrent
bleeding from gastrointestinal vascular malformations:
an overview and systematic review of prospective
observational studies[J]. Digestive Diseases and Sci-ences,
2010, 55(8): 2129-2134.
[4]Sami S S, Al-Araji S A, Ragunath K. Review
article: gastrointestinal angiodysplasia - pathogenesis,
diagnosis and management[J]. Alime-ntary Pharmacology
& Therapeutics, 2014, 39(1): 15-34.
[5] 尉进宏 , 姚建国 . 血管异常致下消化道出血
17 例诊治体会 [J]. 基层医学论坛 , 2013, 17(32): 4277-
4278.
[6]Mora-Luján J M, Iriarte A, Alba E, et al.
Gastrointestinal Bleeding in Patients with Hereditary
Hemorrhagic Telangiectasia: Risk Factors and Endoscopic
Findings[J]. Journal of Clinical Medicine, 2019, 9(1): 82.
[7]Proctor D D, Henderson K J, Dziura J D, et
al. Enteroscopic evaluation of the gastrointestinal tract
in symptomatic patients with hereditary hemorrhagic
telangiectasia[J]. Journal of Clinical Gastr-oenterology,
2005, 39(2): 115-119.
[8] 方青青 , 陈颖 , 陈炜 , 等 . 遗传性出血性毛细
血管扩张症伴消化道出血：1 例报道并文献复习 [J]. 胃
肠病学和肝病学杂志 , 2022, 31(7): 763-769.
[9]Josephson C D, Granger S, Assmann S F, et al.
Bleeding risks are higher in children versus adults given
prophylactic platelet transfusions for treatment-induced
hypoproliferative thrombocytope-nia[J]. Blood, 2012,
120(4): 748-760.
[10]Cortelazzo S, Finazzi G, Buelli M, et al. High risk
of severe bleeding in aged patients with chronic idiopathic
thrombocytopenic purpura[J]. Blood, 1991, 77(1): 31-33.
[11] 中华医学会血液学分会血栓与止血学组，
中国血友病协作组 . 血友病诊断与治疗中国专家共识
（2017 年版）[J]. 中华血液学杂志 ,2017,38(5):364-370.
[12] 徐丽 . 肠内喷洒溃结灵对溃疡性结肠炎患者
肠道粘膜免疫功能及炎症因子水平的影响 [J]. 河北医
学 , 2017,23(3): 401-405.
[13] 沈蕾 , 孙刚 , 张晓梅 . 1187 例上消化道出血急
会诊的病因分析 [J]. 中国医药导报 , 2020,17(31): 111-
114.
[14] 贺凌婕 , 王国兴 , 张澍田 . 上消化道出血病
因分析的单中心回顾性研究 [J]. 临床和实验医学杂志 ,
2019, 18(11): 1189-1191.
[15] 陈颖 , 鲁爽 . 消化性溃疡出血治疗药物临床试
验设计和评价考虑要点 [J]. 中国新药杂志 , 2020,29(14)
: 1576-1582.
[16]Trifilio S, Gordon L, Rubin H, et al. The
non-steroidal anti-inflammatory drug salsalate provides
safe and effective control of mucositis-unrelated pain
during autologous and allogeneic hematopoietic stem cell
transplantation[J]. Supportive Care in Cancer: Official
Journal of the Multinational Association of Supportive Care
in Cancer, 2021, 29(7): 3643-3648.
[17] 黄鸿铃 , 郑霞霞 , 柯敏辉 . 肛瘘术后反复间断
出血的诊治体会（附 1 例报告分析）[J]. 中国肛肠病杂
志 , 2021,41(6): 31-33.
