摘 要：目的：为探讨Dieulafoy病的发病情况及临床特点。方法：无选择地收集国内近12年公开报道的301例及含本例确诊的11例，共312例Dieulafoy病加以综合分析。结果：全组312例中男：女=7：1，中位年龄50.3岁。诱因以饮酒、药物及刺激性食物多见，临床常见呕血、黑便、失血性休克、腹痛及腹胀。首次内镜检查确诊率为53%，部分经2～4次确诊其余病例均经手术证实，病变部位以胃部(269/312)多见，绝大部分位于食管与胃连接部以下6cm范围(218/269)，死亡原因多为失血性休克及伴发疾病。结论：Dieulafoy病临床表现缺乏特异性，对于中年男性无明显先兆的突发消化道出血又无相关病史，应高度怀疑本病。并尽可能及早进行内镜检查及治疗。

    关键词： Dieulafoy； 诱 因； 内镜检查

    The Clinical Analysis of 312 Patients with Dieulafoy Lesion in China

    GUO Jun-xiong, ZHENG Yong- ping, YANG Bi-hui

    (The Central Hospital of Shantou City, Guangdong Shantou 515063, China)

    Abstract：Objective: To investigate the incidence of Dieulafoy lesion and its clinical features. Method: Total 312 cases of Dieulafoy lesion with 301 cases reported openly in recent 12 years national- wide and 11 cases finally diagnosed in our hospital have been enrolled unselectively in our study to be analyzed. Result: In 312 cases, the ratio of male to female is 7 to 1 as well as the median age is 50.3.The most common inducements can be found in alcohol intake, drugs and incentive foods. Haematemesis, melena, hemorrhagic shock, diarrhea and abdominal pain often manifests in clinic. The confirmed diagnosis by first endoscopes examination is 53%, the final diagnosis of partial cases was obtained after 2 to 4 times examination and the rest cases were confirmed by surgery.The lesion mostly located in gastric corpus (269/312), especially in the range of 6cm below gastroesophageal junction (218/269). Therapeutical measures include endoscopic hemostasia and surgery treatment . Total success rate of endoscopic hemostasia reaches 80% (91/127). Hemorrhagic shock and accompanied lesions are the most cause of death. Conclusion: Dieulafoy lesion is lack of clinical specificity, so in Middle- Age patients with sudden upper gastrointestinal hemorrhage of no obvious precursor and no related lesions, Dieulafoy lesion should be highly suspected , which must be underwent endoscopic examination and treatment as quickly as possible. ......