摘要
目的:探讨胶囊内镜检查对双气囊小肠镜进镜方式选择的指导作用．方法:胶囊内镜检查阴性或可疑病变者20例行双气囊小肠镜检查(均在麻醉下进行),包括经口和经肛进镜方式．根据胶囊内镜时间指数 (胶囊内镜从幽门至病灶的通过时间／幽门至回盲瓣的通过时间)选择首次进镜方式,时间指数>0．50时首先考虑经肛进镜检查,对未发现异常者择期改换方式再行检查．分析按胶囊内镜时间指数选择双气囊小肠镜进镜方式的准确性．结果:胶囊内镜检查阴性者5例,行经口双气囊小肠镜检查,有1例在改为经肛检查后检出病灶．胶囊内镜检查怀疑小肠病变者15例,有 12例(80．0％)经双气囊小肠镜结合活检病理确诊．以时间指数>0．50为标准,4例(分别为0．99, 0．8,0．65和0．59)首选经肛进镜检查,后二者(时间指数分别为0．65和0．59)需换从口侧进镜检查而检出病灶;如以时间指数>0．75为标准,该 2例不再需要改换方式再行检查,另2例病变部位被判断为回肠远端,经肛进镜即可准确到达病灶．结论:胶囊内镜检查可指导对双气囊小肠镜进镜方式的选择,时间指数>0．75提示首选经肛进镜检查．
AIM： To evaluate the role of capsule endoscopy in determining the route for double-balloon enteroscopy. METHODS： Twenty patients with negative or equivocal evaluation after capsule endoscopy received double-balloon enteroscopy （under anesthesia with propofol） by oral or anal route. The choice of the insertion route of the endoscope for the first attempt at double-balloon enteroscopy was made according to a time index （the value of the time in minutes for transit of the capsule endoscope from the pylorus to the lesion divided by the value of the time for transit of the capsule endoscope from the pylorus to the cecum）. An anal route was indicated when the time index was more than 0.50. A second procedure was undertaken through the alternative route several days later when the lesion of interest was not found during the first one. The accuracy for choosing the route of double-balloon enteroscopy according to the capsule time index was then analyzed. RESULTS： Five patients with negative evaluation after capsule endoscopy received double-balloon enteroscopy, and a lesion was detected in 1 of these patients when a second procedure by the anal route was performed. Fifteen patients with equivocal evaluation after capsule endoscopy received double-balloon enteroscopy, and the suspected findings were confirmed in 12 （80.0%） of these patients by double-balloon enteroscopy combined with pathological examination. An anal route of the endoscopy at the first attempt with double-balloon enteroscopy was selected on 4 patients （0.99, 0.8, 0.65, and 0.59, respectively）, and the lesions were detected in the latter two （with a time index of 0.65 and 0.59, respectively） when a second procedure by the oral route was performed. If the time index of more than 0.75 （with consideration of another report） was used, no further attempts would be needed in these two patients, and the lesions of the other two patients were assumed to be located in the distal ileum and reached by double-balloon endoscopy via anal route exactly. CONCLUSION： The outcome of capsule endoscopy can direct the choice of routes for double-balloon enteroscopy. A time index of more than 0.75 appears to indicate an anal route as the first procedure.
出处
《世界华人消化杂志》
CAS
北大核心
2006年第18期1828-1832,共5页
World Chinese Journal of Digestology
基金
上海市重点学科建设项目资助
No.Y0205~~
关键词
胶囊内镜
双气囊小肠镜
经口进镜
经肛进镜
Capsule endoscopy
Double-balloon enteroscopy
Anal route
Oral route
