Clinical Study Of Gastrointestinal Vascular Ectasia

ObjectiveTo summarize the clinical characteristics,diagnosis,treatment and prognosis of gastrointestinal vascular ectasia by collecting the clinical data of 102 patients with gastrointestinal vascular ectasia in the hospital.MethodsRetrospectively analyzed the clinical characteristics,diagnosis,treatment and prognosis of 102 patients' data,who were diagnosed with gastrointestinal vascular ectasia in the hospital from February 2007 to June 2019.Results1.General clinical features:In this study,102 patients with gastrointestinal vascular ectasia were enrolled,with an average age of(62±16.2)years,including 44 males and 58 females.The distribution of patients' residence,including 25 urban patients and 77 rural patients.The average hospitalization time of all patients was(11± 7.2)days,of which the longest was 37 days and the shortest was 2 days.The average hemoglobin of all patients was(74±28.0)g / L,the highest was 152 g / L,the lowest was 20 g / L.The location of the lesions was found in 8 cases of stomach,51 cases of small intestine,43 cases of large intestine.In terms of the number of lesions,63 patients with single focus and 39 patients with two or more lesions were involved.There were22 cases with hypertension,3 cases with atrial fibrillation,6 cases with coronary heart disease,8 cases with diabetes and 2 cases with chronic kidney disease.2.Comparative analysis of the clinical characteristics of vascular ectasia indifferent parts of gastrointestinal tract:Through the comparative analysis of the clinical characteristics of gastric,small intestine and large intestine vascular ectasia,we found that there were differences in age and number of lesions,and the difference was statistically significant(P < 0.05).The small intestine is the most common site of disease in patients younger than the average age of 62,while the large intestine is the most common site of disease in patients older than the average age of 62.In terms of the number of lesions,in 8 cases of stomach had single lesion,while patients with single lesion of small intestine vascular ectasia were more than those with multiple lesions.There was no significant difference in the number of patients with single or multiple lesions of large intestine vascular ectasia.There was no statistical difference in gender,residence,length of stay and hemoglobin level.3.Clinical symptoms:Most patients have gastrointestinal bleeding manifestations,including hematemesis in 2 cases,black stool in 58 cases,bloody stool in 36 cases.Some patients had anemia related symptoms,including 9 cases of dizziness,10 cases of asthenia,4 cases of panic.There are also some patients with abdominal pain,abdominal distention and diarrhea,including 11 cases of abdominal pain,1 case of abdominal distention and 1 case of diarrhea.In addition,3 patients showed the change of defecation habit,mainly manifested as the increase of stool frequency.4.Auxiliary examination: In this group of patients,the auxiliary examination includes endoscopy,imaging and laboratory examination.76 cases were examined by endoscopy,including 8 cases by gastroscopy,13 cases by enteroscopy,22 cases by capsule endoscopy and 33 cases by colonoscopy.There are many imaging examination methods in patients with gastrointestinal vascular ectasia.In this study,the imaging examination of patients included:CT enterography(CTE),CT angiography(CTA)and digital subtraction angiography(DSA).In this study,the focus of the collection of patients' laboratory tests include: blood routine,stool routine and occult blood and coagulation related indicators.5.Treatment and prognosis: In this group of patients,the treatment mainly includes medicine and symptomatic treatment,endoscopic treatment and surgical treatment.Drugs and symptomatic support treatment measures include: use of hemostatic drugs,octreotide,thalidomide,blood transfusion,acid suppression and other symptomatic support treatments.Endoscopic treatment measures include: multi-point injection of adrenaline,local spraying of noradrenaline,hemostasis with titanium clip,cauterization with electric tongs,and argon plasma coagulation(APC).17 patients were operated in this group.Through our follow-up,we found that about 22% of the patients in the operation group had recurrent gastrointestinal bleeding,and about 55% of the patients in the non operation group(including endoscopy and drugs)had recurrent gastrointestinal bleeding.ConclusionGastrointestinal vascular ectasia is more common in the elderly,and the lesions are mostly located in the small intestine.The greater the age,the higher the incidence rate of colonic vascular ectasia.Single focus was more than multiple focus in patients with gastric and small intestinal vascular ectasia.Endoscopy is the main method for the diagnosis of gastrointestinal vascular ectasia.The recurrence rate of gastrointestinal bleeding in patients treated with surgery is lower than that of patients treated without surgery.For patients with clear indications,surgical treatment is a better choice and can achieve satisfactory therapeutic effect.