推进式双气囊电子小肠镜在小肠疾病诊断中的评估

An evaluation of small bowel disease diagnosed by double-balloon push enteroscopy

目的 评价推进式双气囊电子小肠镜(double-balloon push enteroscopy,DBE)在小肠疾病诊断中的价值。方法 总结22例疑小肠疾病DBE检查的临床资料,上述患者均经胃镜、肠镜、X线钡餐、小肠钡剂灌肠和血管造影等检查未发现异常。结果 22例共行DBE检查26例次(15例次接受了口侧进镜,11例次接受了肛侧进镜),每侧进镜术程平均80 min。DBE检查共发现异常14例,检出率为63.6％。其中不明原因消化道出血10例,DBE检出病变6例;腹痛和(或)呕吐待查7例,DBE检出病变5例;慢性腹泻待查4例,DBE检出病变2例;不明原因不完全性肠梗阻1例,DBE检出病变1例。口侧进镜患者,术中多数出现恶心、消化液自口经外套管口溢出,偶尔出现一过性轻微腹痛;肛侧进镜患者无明显不适及反应,未出现出血、穿孔等并发症。结论 DBE作为一种新型小肠疾病检查手段,明显优于传统的检查方法,可重复直视操作下观察病灶,通过活检对病变进行定性检查,具有安全、可控性、直视和图像清晰等优点,在诊断小肠疾病方面更具有优越性。

Objective To evaluate the role of double-balloon push enteroscopy (DBE) in diagnosing intestine disease. Methods Tweuty-two patients with suspected small bowel diseases were examined by DBE. All patients had prior normal results on gastroscopy, colonoscopy, small bowel barium radiography and angiograpy. Results Twenty-six procedures were performed in 22 patients, among them 15 patients were performed through mouth and 11 patients through anus. Each procedure sustained 80 minutes in average. DBE disclosed abnormal small bowel findings in 14 out of 22 patients (63.6% ), and 10 of them suffered from GI bleeding, and pathological changes were found in 6 patients by DBE. Seven patients suffered from ab nominal pain and/or vomiting, pathological changes were found in 5 patients. Four patients suffered from chronic diarrhea, and pathological changes were found in 2 of them. one patient suffered from partial small intestine obstruction and pathological changes were found. Nausia, mild temporary abdominal pain and liquids effusing from the overtube occurred during examination through mouth. No severe complications such as hemorrhage, perforation occurred. Conclusion DBE is a new.cc 'rolable and safe endoscopic procedure for small intestinal disease. DBE is superior to conventional methods of small intest al examinations . It has the adventages of allowing direct visualization of the entire small intestine and biopsy.