气囊辅助式小肠镜在诊断Meckel憩室中的应用价值  

The value of balloon-assisted small enteroscopy in diagnosing Meckel's diverticulum

作　　者：郭琼[1] 唐娜娜[1] 焦春花[1] 张红杰[1] 马晶晶[1] GUO Qiong;TANG Nana;JIAO Chunhua;ZHANG Hongjie;MA Jingjing(Department of Gastroenterology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院消化科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2024年第9期1227-1231,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(82070568)。

摘　　要：目的:探讨气囊辅助式小肠镜及其他不同检查方法对小肠Meckel憩室的诊断价值。方法:回顾性分析2010年1月—2023年12月于南京医科大学第一附属医院确诊为小肠Meckel憩室的87例患者,收集患者的一般资料、临床表现、诊断方法、治疗及病理结果等资料,总结归纳临床特征,比较气囊辅助式小肠镜与其他检查方法对小肠Meckel憩室的诊断价值。结果:87例小肠Meckel憩室患者中,55例合并消化道出血、肠梗阻、憩室炎、肠穿孔等并发症。与无并发症患者相比,伴并发症患者中位年龄较小(P=0.003),憩室直径更长[(5.2±2.6)cm vs.(3.3±1.4)cm,P=0.001],开口更宽[(2.4±1.1)cm vs.(1.6±0.7)cm,P=0.002],手术率也更高(89.1%vs.56.3%,P <0.001)。不同检查方法的诊断灵敏度分别为:气囊辅助式小肠镜94.4%,核素显像(异位胃黏膜显像)58.3%,胶囊内镜30.0%,小肠CT 9.4%,腹部CT 8.2%,数字减影血管造影0。结论:年轻患者、憩室直径长、开口宽的小肠Meckel憩室更易合并憩室炎、穿孔、出血、梗阻等并发症。气囊辅助式小肠镜对Meckel憩室的术前诊断价值最高,应作为疑诊小肠Meckel憩室患者的首选检查方法。Objective:To investigate the diagnostic value of balloon-assisted small enteroscopy and other examination methods for Meckel's diverticulum of the small intestine.Methods:A retrospective analysis was conducted on 87 patients diagnosed with Meckel's diverticulum at the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2023.Data regarding demographics,clinical presentations,diagnostic methods,treatments,and pathological findings were collected.Clinical characteristics were summerized,and the diagnostic efficacy of balloon-assisted small enteroscopy was compared with other examination methods for detecting Meckel's diverticulum.Results:A total of 87 patients with Meckel's diverticulum were included,with 55 patients had complications such as gastrointestinal bleeding,intestinal obstruction,diverticulitis,and intestinal perforation.Compared to patients without complications,those with complications had a younger median age(P=0.003),longer diverticulum diameter[(5.2 ± 2.6)cm vs.(3.3 ± 1.4)cm,P=0.001],wider opening[(2.4 ± 1.1)cm vs.(1.6 ± 0.7)cm,P=0.002],and higher surgery rate[(89.1% vs.56.3%,P <0.001].The diagnostic sensitivity of different examination methods for Meckel's diverticulum were as follows:balloon-assisted small enteroscopy 94.4%,nuclide imaging(ectopic gastric mucosal imaging)58.3%,capsule endoscopy 30.0%,small intestine CT 9.4%,abdominal CT 8.2%,and digital subtraction angiography 0%.Conclusion:Young patients with longer diverticulum diameter and wider opening of small intestine Meckel's diverticulumin are more prone to complications such as diverticulitis,perforation,bleeding,and obstruction.Balloon-assisted small enteroscopy has the highest preoperative diagnostic value for Meckel's diverticulum and should be the preferred examination method for patients suspected of having small intestine Meckel's diverticulum.

关 键 词：MECKEL憩室 气囊辅助式小肠镜 诊断 

分 类 号：R574.5[医药卫生—消化系统]