气囊辅助内镜在小肠肿瘤诊治中的应用价值  

Value of the use of balloon-assisted enteroscopy in diagnosis and treatment of small bowel tumor

作　　者：娄红娇 毛高平[1] 宁守斌[1] 唐杰[1] 朱鸣[1] 金晓维[1] 

机构地区：[1]空军总医院消化科,北京100142

出　　处：《解放军医学杂志》2016年第1期54-57,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的研究气囊辅助内镜(BAE)在小肠肿瘤诊治中的应用价值。方法收集我院2007年5月-2014年9月收治的126例临床疑似小肠肿瘤并行BAE检查的患者,其中80例患者同时行腹部CT检查,22例患者同时行消化道钡剂造影检查,24例患者同时行胶囊内镜检查。比较不同检查方法对小肠肿瘤阳性检出率、特异性、敏感性、漏诊率、误诊率等方面的差异。部分患者行BAE镜下治疗并评价其安全性及可行性。结果 BAE对于小肠肿瘤的阳性检出率为92.9%,明显高于腹部CT(47.5%)和消化道钡剂造影(68.2%),但与胶囊内镜(91.7%)比较差异无统计学意义(P>0.05)。BAE与胶囊内镜检查小肠肿瘤的敏感性均为100%,明显高于腹部CT(71.1%)和消化道钡剂造影(66.7%,P<0.01)。BAE检查小肠肿瘤的特异性为100%,明显高于腹部CT(82.9%)、消化道钡剂造影(28.6%)及胶囊内镜(22.2%,P<0.01)。BAE检查与胶囊内镜检查的漏诊率均为0,与腹部CT(28.9%)、消化道钡剂造影(33.3%)比较明显降低(P<0.01)。本组病例中,BAE检查未发现误诊病例,腹部CT误诊率为17.1%,消化道钡剂造影误诊率为71.4%,胶囊内镜误诊率为77.8%,BAE误诊率较腹部CT、消化道钡剂造影、胶囊内镜明显降低(P<0.01)。BAE可对部分小肠肿瘤患者进行镜下治疗。结论BAE检查对小肠肿瘤具有较高的阳性检出率、敏感性及特异性,且对于部分小肠肿瘤的内镜下治疗安全、可靠,具有较高的临床应用价值。Objective To study the value of the use of balloon-assisted enteroscopy（BAE） in the diagnosis and treatment of small bowel tumor. Methods From May 2007 to September 2014, a total of 126 patients with suspected small bowel tumor were enrolled. BAE was performed in all the patients. Of them, abdominal CT scan were performed in 80 patients, gastrointestinal barium radiography in 22, and capsule endoscopy in 24. The positive detection rate, sensitivity, specificity, and the rates of missed diagnosis and misdiagnosis of different examinations were compared. Balloon-assisted endoscopic treatment was conducted in some patients, and its safety and feasibility were assessed. Results The positive rate, sensitivity, and specificity of BAE for suspected small bowel tumor were significantly higher than that of abdominal CT scan, gastrointestinal barium radiography and CE（The positive rates of balloon-assisted enteroscopy, abdominal CT, gastrointestinal barium, capsule endoscopy were 92.9%, 47.5%, 68.2%, 91.7% respectively; their sensitivity 100%,71.1%, 66.7%, 100%, and specificity 100%, 82.9%, 28.6%, 22.2%）, respectively（P〈0.01）, while the rates of diagnostic failure and misdiagnosis were remarkably lowered（The rates of diagnostic failure of balloon assisted enteroscopy, abdominal CT, gastrointestinal barium, capsule endoscopy were 0%, 28.9%, 33.3%, 0%, and the rates of misdiagnosis from these 0%, 17.1%, 71.4%, 77.8% respectively）（P〈0.01）. In a certain number patients with intestinal neoplasm, removal of the tumor could be performed with the aid of BAE. Conclusion With the aid of BAE, the rate of positive diagnostic rate of small bowel tumor is significantly elevated, and it is safe and reliable for endoscopic removal for some small bowel tumors, thus it is valuable in clinical application.

关 键 词：气囊辅助内镜 小肠肿瘤 诊断 治疗 敏感性 特异性 

分 类 号：R735.32[医药卫生—肿瘤]