| Objective:To summarize the clinical features,endoscopic features,explore the endoscopic treatment of digestive tract telangiectasia,evaluate the efficacy and safety of endoscopic treatment,to provide more clinical data for the diagnosis and treatment of digestive tract telangiectasia.Methods:A total of 144,803 patients(including 888,773 cases of gastroscopy,55,884 cases of colonoscopy,146 cases of capsule endoscopy and colonoscopy)who received endoscopy in the digestive endoscopy center of our hospital from January 2017 to December 2020 were screened,retrospectively analyze the clinical data of 1513 patients(1.04%)who were diagnosed with digestive telangiectasis under endoscopy.And further compare the efficacy of endoscopic APC and local spraying of norepinephrine in the treatment of this disease.Results:The average age of 1513 patients was(50.0±12.56)years old,and there were 908(60%)male patients and 605(40%)female patients.The prevalence of male and female patients was significantly different(P<0.0001).There were 1312(86.72%)patients with upper digestive tract telangiectasia,the incidence rate was 1.48%,the most common age was 40-60 years old,and the main lesions were gastric antrum(740/1312,56.4%).There were 198(13.28%)patients with colonic telangiectasia,with a incidence rate of 0.35%.It was mainly seen in the elderly over 60 years old,and the lesions were mainly in the right colon(115/2016,57.2%).There were another 4 cases of small intestinal telangiectasia,of which 1 case involved both ascending colon and small intestine.1164(76.9%)patients had single disease,and 349(23.1%)patients had multiple disease,and the difference was statistically significant(P<0.0001).Most of the patients did not have any clinical manifestations,and 54 patients showed varying degrees of gastrointestinal bleeding.345 patients were treated with endoscopic intervention or treatment,and 290 patients without gastrointestinal bleeding received endoscopic Argon plasma coagulation(APC)for bleeding prevention.The recurrence rate of 66 patients undergoing reexamination under endoscopy was 10.6%.54 patients with gastrointestinal bleeding were given different treatment,3 patients with upper gastrointestinal and colon bleeding were received conservative treatment,2 patients were treated with metal clamps,32 patients received APC treatment,14 patients were treated with endoscopic norepinephrine spraying,in the other 4 patients with small intestinal telangiectasia,2 patients were found by balloon assisted enteroscopy and received endoscopic APC treatment,and 2 patients were observed by capsule endoscopy and received conservative treatment.Conclusion:Digestive tract telangiectasia usually occurs in middle and old age,male is more common than female.It is commonly found on gastric antrum and right colon.The upper digestive tract was more common in patients aged 40 to 60 years,while the colon was more common in patients over 60 years.Most of the lesions are single,which can involve different segments of the digestive tract.The majority of patients with this disease have no clinical symptoms,when the gastrointestinal bleeding caused by the bleeding degree is relatively mild,only a few patients presented as acute massive blood loss.Endoscopy is the main method to diagnose this disease,and the possibility of this disease should be considered for the unexplained gastrointestinal bleeding.Endoscopic therapy is also the most commonly used therapeutic method in clinical practice,and due to the safety,effectiveness and reproducibility of APC,APC treatment can be given priority to patients with well-diagnosed digestive tract telangiectasia.When endoscopic hemostasis fails,interventional treatment or surgical treatment is feasible. |
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