双气囊内镜用于可疑小肠出血性疾病诊断和治疗的临床价值研究  

Value of double-balloon enteroscopy for diagnosis and management of suspected small intestinal bleeding

作　　者：岳辉[1] 周殿元[2] 

机构地区：[1]广东省第二人民医院消化内科,广州510317 [2]南方医科大学南方医院消化疾病研究所,广州510515

出　　处：《中国实用内科杂志》2009年第11期1033-1035,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨双气囊内镜(DBE)对小肠出血性疾病病因诊断和治疗选择的作用。方法2003年6月至2007年8月在广东省第二人民医院和广州南方医院将临床可疑小肠疾病212例,其中疑有小肠出血患者126例,进行DBE检查,发现出血病灶或相关病变进行标记或活检,并与部分手术结果对照。结果可疑小肠出血患者中DBE检查发现小肠出血病变,检出阳性率为80.2%(101/126)。DBE诊断小肠多发性溃疡(含克罗恩病)42例,回肠憩室25例,小肠肿瘤19例,小肠血管畸形10例以及粪类原线虫病2例,钩虫病3例,其中手术治疗39例,术后病理证实33例。16例患者发现非小肠出血的病变,非小肠出血阳性诊断率为12.7%(16/126),消化道出血总体阳性诊断率为92.8%(117/126)。DBE检查未发现明显异常9例。所有患者均未发生严重不良反应和并发症。结论DBE是目前诊断小肠出血最有效的方法之一,无严重不良反应和并发症,可作为首选检查方法。小肠出血的主要病因是良性溃疡(包括克罗恩病)、憩室、肿瘤,其次是血管畸形和寄生虫感染。Objective To evaluate the value of DBE in the diagnosis and selective treatment for suspected small intestinal bleeding and to study possible etiology of small intestinal bleeding. Methods Enteroscopy, using the double-balloon method, were performed in 212 patients with suspected intestinal diseases and 126 patients with suspected small intestinal bleeding from June 2003 and August 2007 at Guangdong No. 2 Provincial People＇s Hospital and Nanfangmedical Universi- ty Hospital. Results The bleeding lesions of small intestine were found in 101 out of 126 patients with suspected intesti- nal diseases （80. 2 % ）, including 42 cases of small intestinal ulcers （ including Crohn＇s diseases） ,25 cases of diverticulum （including Mieheal＇s divertieulesis）, 19 cases of intestinal neoplasms, 10 cases of vascular deformity ,2 cases of stero-pro- nematodiasis and 3 cases of ancylostomiasis; the bleeding lesions of Nan-small intestine （ includingbleeding lesions from stomach,esophagus and large intestine）inl6 out of 126 patients with suspected intestinal diseases（ 12. 7% ） ;9 cases of essentially normality. There were no serious adverse reactions and complications in all patients received enterescopy. Conclusion DBE has higher diagnosis rate for small intestinal bleeding, and can be regarded as the first choice for suspected intestinal bleeding patients. The main reason of small intestinal bleeding are benign ulcers including Crohn＇s disease, in- testine diverticulum and intestinal neoplasms as well as vascular deformity and Parasitosis infection are the rare cause.

关 键 词：小肠出血 双气囊内镜 

分 类 号：R5[医药卫生—内科学]