经双气囊小肠镜诊断小肠憩室内镜下表现及临床特点分析  

Endoscopic findings and clinical features of small bowel diverticulosis diagnosed by double-balloon enteroscopy

作　　者：李成坤 常旭东 曹荣蓉 苏东帅 李英超 王煜晔 刘小毓 邵晓冬 LI Cheng-kun;CHANG Xu-dong;CAO Rong-rong;SU Dong-shuai;LI Ying-chao;WANG Yu-ye;LIU Xiao-yu;SHAO Xiaodong(Department of Gastroenterology,General Hospital of Northern Theater Command,Shenyang 110016,China;Postgraduate Training Base of General Hospital of Northern Theater Command of Jinzhou Medical University,Shenyang 110016,China;Dalian Medical University,Dalian 116000,China)

机构地区：[1]北部战区总医院消化内科,辽宁沈阳110016 [2]锦州医科大学北部战区总医院研究生培养基地,辽宁沈阳110016 [3]大连医科大学,辽宁大连116000

出　　处：《临床军医杂志》2023年第9期892-895,900,共5页Clinical Journal of Medical Officers

基　　金：国家自然科学基金(822706591002635)。

摘　　要：目的分析经双气囊小肠镜(DBE)诊断小肠憩室(SBD)内镜下表现及临床特点,提高临床医师对SBD的认识。方法选取自2009年5月1日至2022年8月31日在北部战区总医院消化内科接受DBE检查的1021例患者为研究对象。收集患者的临床资料,包括性别、年龄,小肠镜检查时间,小肠镜检查诊断结果,确诊为SBD患者的内镜表现,以及SBD患者的临床症状。分析SBD内镜下表现及临床特点。结果1021例患者中,共检出SBD 44例,总检出率为4.31%(44/1021)。其中,男性患者SBD检出率为4.11%(28/682),女性为4.72%(16/339),不同性别患者的SBD检出率比较,差异无统计学意义(P>0.05)。年龄≤50岁患者SBD检出率为4.06%(24/591),年龄>50岁为4.65%(20/430),不同年龄患者SBD检出率比较,差异无统计学意义(P>0.05)。2009—2015年期间检查的患者620例,SBD检出率为3.87%(24/620),2016—2022年期间检查的患者401例,SBD检出率为4.99%(20/401),不同检查年份患者的SBD检出率比较,差异无统计学意义(P>0.05)。经口DBE的SBD检出率为4.19%(18/430),经肛DBE的SBD检出率为4.40%(26/591),经口DBE和经肛DBE的SBD检出率比较,差异无统计学意义(P>0.05)。有15例(34.09%)SBD患者出现并发症,其中,5例并发憩室炎症,9例并发憩室出血,1例并发粪石嵌顿;29例(65.91%)无并发症。最常见的临床症状为便血/黑便。结论SBD的检出率与患者性别、年龄、检查年份和检查方式无关;SBD检出率最高的部位因检查方式不同而异,大部分为小肠单发憩室;并发症以憩室出血多见,并发憩室出血后以外科手术治疗为主。Objective To analyze the endoscopic features and clinical characteristics of the diagnosis of small intestinal diverticula(SBD)by double balloon enteroscopy(DBE),and to improve the understanding of SBD.Methods A total of 1021 patients who received DBE examination in the Department of Gastroenterology of General Hospital of Northern Theater Command from May 1,2009 to August 31,2022 were selected as the study subjects.Clinical data of patients were collected,including gender,age,colonoscopy time,colonoscopy diagnosis results,endoscopic manifestations of patients diagnosed with SBD,and clinical symptoms of patients with SBD.The endoscopic manifestations and clinical characteristics of SBD were analyzed.Results Among the 1021 patients,44 cases of SBD were detected,with a total detection rate of 4.31%(44/1021).Among them,the detection rate of SBD in male patients was 4.11%(28/682)and that in female patients was 4.72%(16/339).There was no statistical significance in the detection rate of SBD among different genders(P>0.05).The detection rate of SBD in patients≤50 years old was 4.06%(24/591),and that in patients>50 years old was 4.65%(20/430).There was no statistical significance in the detection rate of SBD among patients of different ages(P>0.05).Among the 620 patients examined from 2009 to 2015,the detection rate of SBD was 3.87%(24/620),and among the 401 patients examined from 2016 to 2022,the detection rate of SBD was 4.99%(20/401).The detection rate of SBD among patients in different examination years was compared.There was no significant difference(P>0.05).The SBD detection rate of transoral DBE was 4.19%(18/430),and that of transanal DBE was 4.40%(26/591).There was no significant difference in the SBD detection rate between transoral DBE and transanal DBE(P>0.05).There were 15 cases(34.09%)of SBD patients with complications,of which 5 cases with diverticular inflammation,9 cases with diverticular bleeding,1 case with fecalith incarceration.There were no complications in 29 cases(65.91%).The most common clinica

关 键 词：小肠憩室 双气囊小肠镜 临床特点 内镜 出血 

分 类 号：R574[医药卫生—消化系统]