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双气囊小肠镜对小肠出血的临床诊治价值

Clinical diagnostic and therapeutic value of double-balloon enteroscopy in small bowel bleeding
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摘要 目的探讨双气囊小肠镜对小肠出血性疾病的临床诊疗价值。方法回顾性分析汕头市中心医院内镜中心2019年8月至2023年5月因小肠出血行双气囊小肠镜检查87例患者的临床资料,分析双气囊小肠镜对小肠出血病因的诊疗情况。结果87例小肠出血患者共进行117次双气囊小肠镜检查,其中,单侧经口进镜29次,单侧经肛进镜28次,30例患者同时进行经口经肛双侧进镜检查,经口进镜深度大于经肛进镜,且经口进镜检查时间少于经肛进镜检查时间。双气囊小肠镜诊断率为83.91%,病理诊断准确率为83.78%。小肠肿瘤是本研究中导致小肠出血的主要病因,小肠间质瘤是小肠肿瘤中最常见的病理类型,年龄>40岁人群中出现小肠肿瘤的频率要高于年龄≤40岁人群,差异有统计学意义(P<0.05)。克罗恩病发生在回肠的频率高于空肠,年龄≤40岁人群中发生克罗恩病的频率高于年龄>40岁人群,差异均有统计学意义(P<0.05)。共有14例小肠出血患者经双气囊小肠镜行内镜下止血成功,所有患者术中均未出现消化道穿孔、严重出血等并发症。结论双气囊小肠镜对小肠出血性疾病具有较高的诊断价值,必要时可进行内镜下治疗,是一种安全、可靠、实用的诊疗方法。 Objective To discuss the clinical diagnosis and treatment value of double-balloon enteroscopy for small intestinal bleeding diseases.Methods Retrospective collection of clinical data from 87 patients who underwent double-balloon enteroscopy for small bowel bleeding in Shantou Central Hospital from August 2019 to May 2023,and analysis of the diagnosis and treatment of small bowel bleeding causes by double-balloon enteroscopy.Results Totally 87 cases of small intestinal bleeding patients underwent a total of 117 double-balloon enteroscopy examinations,with 29 performed orally and 28 performed anally,and 30 cases simultaneously underwent both oral and anal bilateral enteroscopy examinations,with the depth of oral examination greater than that of anal examination,and the duration of oral examination shorter than that of anal examination.Among them,with a diagnostic rate of double-balloon enteroscopy at 83.91%and a pathological diagnostic accuracy rate at 83.78%.Small intestinal tumors were the main cause of small intestinal bleeding in this study,with gastrointestinal stromal tumors being the most common pathological type among small intestinal tumors.The frequency of occurrence for small intestinal tumors in individuals over 40 years old was higher than those under or equal to 40 years old group,showing statistical significance.Crohn’s disease occurred more frequently in the ileum compared to jejunum,and its frequency was higher in individuals under or equal to 40 years old compared to those over 40 years old group,both differences were statistically significant(P<0.05).A total of cases of small intestinal bleeding patients successfully underwent endoscopic hemostasis via double-balloon enteroscopy without any complications such as gastrointestinal perforation or severe bleeding during surgery.Conclusion Double balloon enteroscopy has a high diagnostic value for small intestinal bleeding and can provide basis for clinical treatment.
作者 许选 叶晓丹 郭燕环 王小忠 XU Xuan;YE Xiaodan;GUO Yanhuan;WANG Xiaozhong(Endoscopy Center,Shantou Central Hospital,Shantou 515000,Guangdong,China)
出处 《中国现代医生》 2024年第32期61-65,共5页 China Modern Doctor
关键词 双气囊小肠镜 小肠出血 诊断 Double-balloon enteroscopy Small bowel bleeding Diagnosis
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