245例双气囊电子小肠镜检查应用分析  

Applied analysis of double-balloon enteroscopy in 245cases

作　　者：李邦库[1] 谢惠君[1] 胡乃中[1] 许建明[1] 杨桂芳[1] 方加旭[1] 

机构地区：[1]安徽医科大学第一附属医院消化内科,合肥230022

出　　处：《安徽医学》2011年第4期423-425,共3页Anhui Medical Journal

基　　金：安徽省卫生厅医学科学研究计划标志性技术项目(编号05A007)

摘　　要：目的评价双气囊电子小肠镜对小肠疾病患者的诊断价值及其安全性。方法对2007年2月至2010年7月间245例有消化道症状,经胃镜、结肠镜等检查为阴性者,采用双气囊电子小肠镜检查,根据病情选择进镜方式。结果 244例完成预定检查,1例患者因回盲瓣严重变形,检查失败,小肠镜未能进入回肠。在244例完成双气囊电子小肠镜检查患者中,有阳性发现206例,病变检出率84.4%(206/244),病因诊断率77.8%(190/244)。检出的疾病有:小肠非特异性炎症36例,小肠血管畸形24例,小肠息肉21例,小肠克罗恩病18例,小肠恶性肿瘤17例,小肠憩室22例,小肠间质瘤21例,糜烂出血性回肠炎1例,十二指肠溃疡2例,回肠吻合口溃疡1例,空肠柿石1例,出血坏死性小肠炎2例,过敏性紫癜1例,腭裂溃疡伴出血1例,肠钩虫感染13例等。双气囊电子小肠镜对不明原因消化道出血的诊断率为79.6%(115/142),对不明原因小肠梗阻的病因诊断率为77.6%(66/85)。所有患者检查过程中未发生严重并发症,只有咽喉部不适、轻度疼痛感,腹痛、腹胀、肛门不适等,患者均能忍受完成检查。结论双气囊电子小肠镜能安全、快速地检查全小肠,对小肠疾病诊断有较高价值,并且很安全。Objective To evaluate clinical efficacy and safety of double-balloon enteroscopy for small bowel diseases.Methods 245 cases of small bowel diseases with negative findings of various routine diagnostic modalities were performed with double-balloon enteroscopy.From February2007 to May2010.Starting insertion route（oral or anal） of double-balloon enteroscopy was chosen according to the estimated location of the suspected lesions basing on the clinical presentation and on the fingings.Results The lesion was detected in 206 of 244 cases,the total positive rate of double-balloon enteroscopy was 84.4%（206/244）,the diagnostic yield was 77.8%（190/244）.the findings were non-specific enteric inflammation 36 cases,vascular deformity 24 cases,polyps 21 cases,Crhonˊs disease 18 cases,adenocarcinoma 17 cases,small bowel diverticulosis 22 cases（Michael diverticulosis with ulcer 3 case）,erosive and haemorrhagic ileitis 2 cases,duodenal ulcer 2 cases,entro-mesenchymoma 21 case,marginal ulcer 1 case,phytobezoars in jejunal 1 case,allergic purpura 1 case,ancylostomiasis 13 case.Most of patients were fairly tolerate to the procedure.No procedure-related complications were observed in all cases.Conclusion Double-balloon enteroscopy was safe,reliable diagnostic modality of high clinical value for small intestinal diseases.

关 键 词：肠疾病 诊断 双气囊电子小肠镜 

分 类 号：R574[医药卫生—消化系统]