摘要
目的探讨胶囊内镜(CE)、双气囊小肠镜(DBE)进行的小肠深段内镜检查(DSBE)在克罗恩病(CD)诊断中的价值。方法归纳并分析2004年01月～2008年12月5年间南方医院确诊且接受CE、DBE检查的54例CD患者的消化道内镜及相关临床资料。结果患者行DSBE的主要指征为疑似CD(42.6%)及不明原因性消化道出血(25.9%)。小肠深段病变的镜下形态以非特异性为主,多呈节段性分布。小肠DSBE明显优于钡剂影像检查;DSBE病变检出率(92.6%)高于结肠镜检查(75.9%,P=0.017),其所提供的CD特征性表现,如节段性肠段分布、肠腔变形,较结肠镜检查明显增加。DSBE能显著改善患者的诊断情况,但倾向于提供疑似CD的指导性判断。结论 DSBE有助于小肠段CD病变的检出及受累范围的评估,为CD的诊断、鉴别和复查等提供依据和指向;适当选用DSBE并将其结果与常规影像、胃肠镜及临床等资料综合、分析,将增强DSBE在CD诊治中的作用及有效性。
Objective To evaluate the value of deep small-bowel endoscopy（DSBE） in the diagnosis of Crohn＇s disease（CD）.Methods The endoscopic and clinical data of 54 patients with CD receiving capsule endoscopy（CE） and double-balloon enteroscopy（DBE） between January,2004 and December,2008 were summarized and analyzed retrospectively.Results The main indications for DSBE in our series were suspected CD（42.6%） and obscure gastrointestinal bleeding（25.9%）.DSBE was obviously superior to barium imaging.The detection rate of CD was significantly higher with DSBE（92.6%） than with ileocolonscopy（75.9%,P=0.017）,and DSBE provides much more detailed descriptions of specific endoscopic features such as segmental distribution and lumen changes.DSBE significantly improve the diagnostic efficiency,giving priority to offer a guide and raise suspected diagnosis for CD.Conclusion DSBE is a valuable modality for detecting CD lesions in the jejunum and ileum and for evaluating lesion involvement and severity.The combination with a comprehensive analysis of routine imaging findings,gastroendoscopy,and clinical data can further enhance the diagnostic efficiency of DSBE.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2011年第4期637-640,共4页
Journal of Southern Medical University
基金
国家自然科学基金(81070291)
广东省自然科学基金(9151051501000048)~~
关键词
深段小肠
克罗恩病
双气囊小肠镜
胶囊内镜
deep small bowel
Crohn＇s disease
capsule endoscopy
double-balloon enteroscopy
