摘要
目的探讨不明原因消化道出血（OGIB）患者干亍双气褒小肠镜（DBE）完成全小肠检查的可行性及其在OGIB诊治中的价值。方法收集武汉大学人民医院消化内科2010年1月至2015年12月期间行DBE榆查的OGIB患者的内镜、临床资料进行同顺性分析。结果36．3％（136／375）OGIB患者需完成全小肠检查，成功率86．0％（117／136），井发症发生率1．5％（2／136）。完成全小肠榆食者44．4％（52／117）未发现病变，6．8％（8／117）发现非小肠病变，48．7％（57／117）发现小肠病变。未发现病变者再出血发生率8．9％（4／45），检查发现小肠间质瘤和胃底Dieulafoy’8病各1例。未完成全小肠检查亦未发现病变者再出血发生率33．3％（5／15），检奄发现小肠息肉和血管扩张各1例。结论DBE可安全有效地在1d之内完成全小肠检查，对OGIB诊治具有重要意义。DBE未发现小肠出血病变者还』巫考虑非小肠病变、漏诊小肠病变或未探及小肠存在出血病变的可能。
Objective To investigate the feasibility and application value of total enteroscopy with double balloon enteroseopy （DBE） for diagnosis and treatment of patients with obscure gastrointestinal bleeding （OGIB）. Methods The clinical and endoscopic data of patients underwent DBE for OGIB in the Department of Gastroenterology, Retain Hospital of Wuhan University from January 2010 to December 2015 were retrospectively analyzed. Results Total enteroscopy was indicated in 36. 3% （136/375） of patients. The success rate was 86. 0% （117/136） and complication rate was 1.5% （2/136）. Negative findings, non- small bowel lesions and small bowel lesions were detected in 44. 4% （52/117） , 6. 8% （ 8/117）, and 48.7% （57/117） of patients with total enteroscopy. Re-bleeding occurred in 8.9% （4/45） of patients with negative total enteroseopy, while I small bowel mesenchymonm and 1 gastric fundus Dieulafoy＇s lesion were revealed subsequently. Re-bleeding occmTed in 33.3% （5/15） of patients with incomplete enteroscopy, and 1 small bowel polyp and 1 small bowel angiectasis were revealed subsequently. Conclusion DBE can complete total enteroscopy within one day and provide important clinical information of OGIB. Non-small bowel lesions, small bowel lesion missed by DBE and potential bleeding lesions in small bowel beyond the reach of DBE should be considered in patients with negative enteroscopy.
出处
《中华消化内镜杂志》
CSCD
北大核心
2017年第9期640-644,共5页
Chinese Journal of Digestive Endoscopy
关键词
双气囊小肠镜
不明原因消化道出血
小肠
全小肠检查
Double-balloon enteroscopy
Obscure gastrointestinal bleeding
Small bowel
Total enteroscopy
