摘要
目的:系统地评价双气囊小肠镜(double-balloon endoscope,DBE)对小肠疾病的诊断率、观察范围、并发症等,探讨其诊断价值和安全性.方法:对怀疑或证实有小肠疾病的1036例患者(男性585例,女性451例)在异丙酚麻醉/镇静状态下进行1202例(经口检查589例,经肛门检查613例,双侧对接检查184例)DBE检查.结果:1202例次的检查中,检查成功率99.2%(1193/1202),小肠病变阳性检出率84.5%(875/1036).小肠疾病的类型前3位的是息肉和肿瘤(391/875;44.7%)、糜烂和溃疡(246/875;28.1%)、血管畸形(52/875;5.94%).平均检查时间78 min±43 min(30-180 min).经口进镜长度231 cm±74 cm,经肛进镜长度176 cm±69 cm,两者比较差异有统计学意义(P<0.05).DBE对不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)的病因诊断中前3位的是糜烂和溃疡(57/218,26.1%)、血管性病变(33/218,15.1%)、息肉和肿瘤(28/218,12.8%).63例小肠肿瘤中45例(45/63,71%)为恶性肿瘤,18例(18/63,29%)为良性肿瘤,以小肠恶性肿瘤为主.小肠肿瘤的内镜诊断与镜下病理诊断准确率为87.5%(63/72).严重并发症11例(11/1202,0.915%),小部分患者术后诉轻微的咽喉不适、肛门部疼痛和腹胀.结论:DBE是一种安全可靠地诊断小肠疾病的检查方法,通过直视下的小肠活检以协助病因学鉴别,应用前景广阔.
AIM： To systematically analyze data on diagnostic rate, observation scope, and complications of double-balloon endoscopy （DBE） for small bowel diseases, and to further evaluate its clinical value and security.METHODS： A total of 1036 patients （585 men and 451 women） with suspected or known small-bowel diseases underwent 1202 DBE procedures （oral 589, anal 613, both approaches 184） under anesthesia with propofol at our institution over the past decade.RESULTS： The success rate of DBE was 99.2% （1193/1202）, and the positive diagnostic yield was 84.5% （875/1036）. The main diagnosis was polyps and tumors （391/1202; 32.5%）, erosions and ulcerations （246/1202; 20.4%）, and angiodysplasia （52/1202; 4.32%）. The mean duration of the procedure was 78 min ± 43 min （30-180 min）. On average, 231 cm ± 74 cm of the small bowel was visualized by using the oral route and 176 cm ± 69 cm by using the anal route （P 〈 0.05）. Most common lesions detected in patients with OGIB （obscure gastrointestinal bleeding） were ulcers and erosions （57/218; 26.1%）, vascular diseases （33/218; 15.1%）, and tumors and polyps （28/218; 12.8%）. Among 63 small bowel tumor cases, 45 were malignant （45/63; 71%） and 18 were benign （18/63; 29%）. Histopathology was consistent with the endoscopic diagnosis in 87.5% （63/72） of patients with small bowel tumors. Severe complications were observed in 11/1202 （0.915%） of cases. A minority of patients complained of mild sore throat, anal pain or abdominal distension after the DBE procdure.CONCLUSION： Our retrospective analysis shows that DBE is a safe and effective method to diagnose small bowel disorders by visualization and tissue sampling to assist in diagnosis of etiology.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第11期1616-1621,共6页
World Chinese Journal of Digestology
关键词
双气囊电子小肠镜
小肠疾病
诊断
Double-balloon endoscopy
Small intestinal diseases
Diagnosis
