双气囊推进式小肠镜的临床应用  

Double-balloon Enteroscopy Application in the Small Bowel Diseases

作　　者：刘吉勇[1] 姜军梅[1] 林立明[1] 姜红[1] 宫铭[1] 夏新玲[1] 

机构地区：[1]山东省立医院消化内科,济南250021

出　　处：《中国医疗器械信息》2006年第8期22-24,共3页China Medical Device Information

摘　　要：目的：双气囊推进式小肠镜的发展使医生能够直接观察小肠,本研究的目的在于探讨该设备在结肠镜和胃镜检查均阴性的55例患者中的诊断和治疗意义。方法：采用双气囊推进式小肠镜EN-450P,在检查过程中,大部分患者采用清醒镇静,注意观察记录患者的并发症、检查时间、进镜途径及检查阳性率。患者的症状和体征、诊断和预后都有详细记载。结果：本组患者的检查结果的阳性率为94.5%(52/55),其中不明原因的小肠出血占43.6%(24/55),是该项检查的主要适应症,平均检查时间是45分钟。3例患者因为没有获得全肠道的检查而未确诊,从而从相反地方向重新检查。5例患者获得全胃肠检查。在镇静剂的帮助下,患者可以很好的耐受检查。3例患者因为腹腔严重粘连导致进镜困难而放弃检查。所有的患者均有随访。大多数器质性疾病(除了病变部位有活动性出血)的患者均有病理诊断。一位胃大部切除患者发生肠扭转造成肠梗阻,在完成检查后,完全恢复。结论：双气囊推进式小肠镜能够肉眼观察全小肠,并能够得到病理诊断,并能够大体对病变进行定位。在镇静剂的帮助下,患者能够很好的耐受检查。它的适应症为：不明原因的消化道出血、慢性腹泻、慢性腹痛和不完全肠梗阻。它不仅是一项检查手段,在某种意义上来说,它还可以是一种治疗手段。检查失败的主要原因是腹腔粘连。The development of the double-balloon enteroscopy （DBE） allows to observing the intestine directly. The aim of the study was to evaluate the clinical significance of the DBE in a series of 55 patients with colonoscopy and gastroscopy negative intestinal lesions.Methods：ADBE was used,during the examination;sedatives were used by most of the patients.The complications,the examination time and the routine of the insertion and positive rate were paid attention to .The symptoms and signs of the patients ,examination result and the prognosis of the patients were recorded in detail.Result：The positive rate of the examination in this trial was 94.5%（52/55）,intestinal bleeding with obscure reasons 43.6%（24/55）was the main indications that called for this examination.The average examination time was 45 minutes.Three patients were re-examinated from the opposite direction because of no diangosis without complete examination.The entire small bowel was complitely explored in 5 patients,The patients could endure the examination with the help of sedatives.Three patients gave up because of severe abdominal adhesions or difficulty of pushing the enterscope.All patients were followed up.Most of the patients with tumor or bowel inflammation had the pathological diagnosis except those who had active bleeding in the lesion sites.One patient with intestinal volvulus after the partly gastroectomy recovered because of the pull and push action of the examination.Conclusions.DBE could observe the total intestine and diagnose the diseases by naked eyc and biopsy.It can decide the site of the site roughly,and can be accepted by the patients with the help of sedatives.The examination should be recommended to the patient who has any symptom such as bleeding with obscure reason,chronic diarrhea,chronic abdominal pain and incomplete intestine obstruction,It is not only a examination but also can be a therapeutic endoscopy in some sense.The most failure reason is abdomina addhesion and the suppression of the small bowel.

关 键 词：双气囊推进式小肠镜 小肠疾病 

分 类 号：TH776.1[机械工程—仪器科学与技术]