摘要
目的比较双气囊小肠镜与胶囊内镜在小肠出血中的病变检出率、病因诊断率、耐受性和安全性,初步探讨双气囊小肠镜对小肠出血的内镜下治疗。方法2006年4月至2009年10月烟台毓璜顶医院消化内科收治的可疑小肠出血患者159例,其中81例患者行双气囊小肠镜检查,首选进镜方式分为经口或经肛2种,首选方式检查后未发现病灶者,日后改换进镜方式再行检查。对活动性出血病灶行内镜下止血治疗。另78例患者行胶囊内镜检查。两组患者分别由专门医师独立操作并诊断,最后进行汇总分析,对比双气囊小肠镜与胶囊内镜的临床应用价值。结果双气囊小肠镜组的病变检出率为95.06%,病因诊断率为82.72%,23例检查时见病变活动性出血,行内镜下止血治疗,21例止血成功,内镜止血成功率为91.30%;胶囊内镜组的病变检出率82.05%,病因诊断率为66.67%。双气囊小肠镜组的病因检出率及病因诊断率均显著高于胶囊内镜组,差异有统计学意义(P<0.05)。在耐受性方面,胶囊内镜的耐受性最好,双气囊小肠镜的耐受性依次为:全麻下经肛进镜、全麻下经口进镜、非麻醉经肛进镜、非麻醉经口进镜。所有患者均未发生严重并发症。结论双气囊小肠镜对小肠出血的病因诊断明显优于胶囊内镜,并且可行内镜下止血治疗,是一项安全、有效的临床诊疗方法。
Objective To compare the diagnostic power, the etiological diagnostic accuracy, patient＇s tolerance and safety of double balloon enteroscopy and capsule endoscopy in patients with small intestine bleeding. To explore the endoscopic therapy of double balloon enteroscopy for small intestine bleeding. Methods In 159 patients with small intestine bleeding in Department of Gastroenterology of Yantai Yuhuangding Hospital from April, 2006 to October, 2009, double balloon enteroscopy was performed in 81 patients .The route of enteroscopy could be undergone either via mouth or via anus. If the result was negative in initial route, another examination was required either via mouth or via anus. For active small intestinal bleeding detected during examination, endoscopic hemostasis was done. Capsule endoscopy was performed in 78 patients. The results of both methods were analyzed independently and final diagnosis of each case was compared thereafter to evaluate the clinical value of double balloon enteroscopy and capsule endoscopy. Results The overall diagnostic rate for double balloon enteroscopy was 95.06%, and the etiological diagnostic accuracy was 82.72%. Active bleedings were detected in 23 cases, endoscopic hemostasis was successfully made in 21 cases （91.30%）. The overall diagnostic rate for capsule enteroscopy was 82.05%, and the etiological diagnostic accuracy was 66.67%. Double balloon enteroscopy was superior to capsule endoscopy in the diagnostic power and the etiological diagnosis of small intestinal bleeding （P 〈 0.05）. Patient＇s tolerance was better for capsule endoscopy than for double balloon enteroscopy. Toleration of double balloon enteroscopy was in turn under anaesthesia via anus, under anaesthesia via mouth, via anus without anaesthesia and via mouth without anaesthesia. No serious complications occurred in all patients. Conclusions Double balloon enteroscopy is superior to capsule endoscopy in the diagnosis of small intestinal bleeding and endoscopic hemostasis.
出处
《现代消化及介入诊疗》
2010年第1期14-19,共6页
Modern Interventional Diagnosis and Treatment in Gastroenterology
关键词
双气囊小肠镜
胶囊内镜
小肠出血
Double balloon enteroscopy
Capsule endoscopy
Small intestine bleeding
