- 期刊
消化道「血管異常增生」出血之診斷及治療
Diagnosis and Treatment of Gastrointestinal Tract Angiodysplasias with Bleeding
摘要
消化道「血管異常增生」(angiodysplasia)的出血在臨床上並不少見，可能造成患者有明顯的(overt)或隱晦性的(occult)腸胃道出血，甚至造成不明原因消化道出血(obscure gastrointestinal bleeding)-指在臨床上有反覆的消化道出血或無法解釋的缺鐵性貧血，在接受過傳統的胃鏡及大腸鏡檢查後，仍無法找到出血點。「血管異常增生」的位置若是胃鏡、大腸鏡可及之處，可直接在做內視鏡時加以治療，但如果其位置是在小腸，這對腸胃科醫師是一大挑戰，因爲小腸平均有6.7公尺長，傳統的胃鏡及大腸鏡檢查無法找到出血點，患者也可能多次進出醫院，苦不堪言。但目前已有新的診斷工具－膠囊內視鏡(capsule endoscopy)及氣囊式小腸鏡(balloon assist enteroscopy: double or single balloon)可針對小腸做充份的檢查。治療方面除了內視鏡治療、手術治療之外，因患者原有疾病的關係常會復發，所以藥物治療（荷爾蒙、thalidomide、non-selective beta-blocker）目前是非常具有前景的療法。
並列摘要
Gastrointestinal tract angiodysplasias with bleeding is not uncommon. This may cause overt or occult gastrointestinal bleeding. If the bleeding source can not be detected by traditional panendoscope and colonoscope, the diagnosis of obscure gastrointestinal bleeding is made. If the bleeding point of angiodysplasias with bleeding is in the small intestine, it challenging for a gastroenterologist. Because the average length of the small intestine is 6.7meters, it is difficult to examine the entire small intestine using a traditional panendoscope and colonoscope. Patients with obscure GI bleeding suffer a great deal and they may be required to consult at hospitals repeatedly. Now new modalities, such as capsule endoscopy and balloon assist enteroscopy are available, which can examine the entire small intestine. The therapeutic function of balloon assist enteroscopy results in increasing the necessity of surgical intervention. Furthermore, medical treatment (hormone, thalidomide, etc.) to prevent recurrent gastrointestinal angiodysplasias with bleeding seems to be promising.