Diagnostic Effects and Influence Factors of Emergency Colonoscopy in Patients with Acute Lower Gastrointestinal Massive Hemorrhage / 昆明医科大学学报

ABSTRACT

Objective To analyze the diagnostic effects and influence factors of emergency colonoscopy in patients with acute lower gastrointestinal massive hemorrhage. Methods 56 cases of patients with acute lower gastrointestinal massive hemorrhage treated in our hospital from May 2016 to May 2017 were selected and treated with emergency colonoscopy. The causes of acute lower gastrointestinal massive hemorrhage were analyzed and the emergency colonoscopy completion conditions in patients with different bowel preparation methods and different degrees of bleeding were compared. According to the results of emergency colonoscopy, the patients were divided into the successful test group and the failed test group, and the clinical data of the two groups were compared, and the influencing factors of the emergency colonoscopy were analyzed. Results The causes of acute lower gastrointestinal massive hemorrhage were colon cancer, colonic polyps,colon diverticulum and so on. There was no significant difference in the rebleeding or bleeding aggravation rate of different intestinal preparation methods (P＞0.05), and the detection rate of active bleeding in the severe hemorrhage group was higher than that in the mild hemorrhage group and the moderate hemorrhage group (P＜0.05) . In the emergency colonoscopy group, the number of patients in the successful test group, who were females, aged more than 45 years old, with a appendectomy history, a short walking time during the medication, an inadequate intestine preparation, unfinished lustramentum before examination, intestinal anatomical abnormalities and a non-standard physician operation,were lower than those in the failed test group (P＜0.05) . Logistic regression analysis showed that being female, aged over 45, inadequate bowel preparation and intestinal anatomical abnormalities were the independent risk factors for emergency colonoscopy failure in patients with acute lower gastrointestinal massive hemorrhage (P＜0.05) .Conclusions Emergency colonoscopy has important diagnostic significance for acute lower gastrointestinal massive hemorrhage especially the moderate to severe hemorrhage. Female, aged more than 45 years old, inadequate intestinal preparation and intestinal anatomical abnormalities are the independent influencing risk factor for diagnostic effects.