透明帽在经肛单气囊小肠镜检查中的临床应用  

Clinical Application of Transparent Cap in Retrograde Single-balloon Enteroscopy

作　　者：孙玉洁[1] 房静远[2] 金雪琴[1] 孙英[1] SUN Yujie;FANG Jingyuan;JIN Xueqin;SUN Ying(Department of Gastroenterology,Suzhou Wuzhong People’s Hospital,Suzhou,Jiangsu Province,215128;Division of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai)

机构地区：[1]苏州市吴中人民医院消化内科,215128 [2]上海交通大学医学院附属仁济医院消化内科

出　　处：《胃肠病学》2021年第10期590-593,共4页Chinese Journal of Gastroenterology

摘　　要：背景:小肠镜检查可行内镜下活检明确病灶性质,对小肠疾病有较高的诊断价值。经肛单气囊小肠镜检查(SBE)因受结肠肠段影响,操作较为困难。透明帽在内镜诊疗中已被广泛应用,有利于进镜和稳定肠腔。目的:探讨透明帽在经肛SBE检查中的作用。方法:苏州市吴中人民医院64例行经肛SBE检查的患者纳入研究,按随机数字表法分为2组,每组32例。试验组行透明帽辅助SBE检查,对照组行常规SBE检查,由同一名经验丰富的主任内镜医师完成操作。比较两组到达回盲部时间、回肠末端插管成功率、进镜深度、病变检出率和并发症发生情况。结果:试验组到达回盲部平均时间为(11.8±2.0) min,较对照组的(13.6±2.8) min明显缩短,回肠末端插管成功率明显高于对照组(100.0%对81.2%),进镜亦更为深入[(209.8±46.1) cm对(188.3±40.3) cm],差异均有统计学意义(P均<0.05)。两组间病变检出率无明显差异(81.2%对62.5%,P>0.05)。两组患者均未出现严重并发症。结论:透明帽辅助有助于降低经肛SBE检查的进镜难度,提高操作效率,缩短检查时间,适合临床推广应用。Background: Enteroscopy-based biopsy pathology has high diagnostic value for suspected small bowel diseases. Retrograde single-balloon enteroscopy(SBE) is difficult to operate due to the influence of colonic segment. Transparent cap has been widely used in the diagnostic and therapeutic endoscopic procedure, which is conducive for inserting the enteroscope and stabilizing the intestinal cavity. Aims: To explore the role of transparent cap in retrograde SBE. Methods: A total of 64 cases of patients who were hospitalized for retrograde SBE in Suzhou Wuzhong People’s Hospital were recruited and allocated into 2 groups according to the random number table method, with 32 cases in each group. Patients in experimental group received cap-assisted SBE and those in control group received routine SBE. All procedures were performed by an experienced senior endoscopist. Outcomes measured included time to reach the ileocecus, terminal ileum intubation rate, depth of insertion, diagnostic yield, and the related complications. Results: The mean time to reach the ileocecus was shorter in experimental group than in control group [(11.8±2.0) min vs.(13.6±2.8) min, P<0.05], the terminal ileum intubation rate(100.0% vs. 81.2%, P<0.05) and depth of insertion [(209.8±46.1) cm vs.(188.3±40.3) cm, P<0.05] between the two groups were also different with statistical significance. However, there was no significant difference in the diagnostic yield between the two groups(81.2% vs. 62.5%, P>0.05). No severe complications were observed in all the cases. Conclusions: Cap-assisted retrograde SBE is an efficient method for optimizing the intubation rate, insertion depth and procedure time, and is suitable for promotion in clinical practice.

关 键 词：经肛单气囊小肠镜检查 透明帽 回肠末端插管 

分 类 号：R574[医药卫生—消化系统]