小肠血管畸形出血的胶囊式内镜诊断及肠镜辅助定点切除

Capsule endoscopic diagnosis and treatment with intraoperative endoscopic assistance of vascular malformation of small intestine with bleeding

目的探讨小肠血管畸形出血的胶囊式内镜诊断及肠镜辅助下手术治疗的方法和疗效.方法回顾性分析本院2003年1月至2004年8月130例胶囊式内镜检查病例中诊断为血管畸型的11例临床资料.结果胶囊式内镜诊断为小肠血管畸形出血的11例病人中,术后病理证实为血管畸形者10 例,均表现为无痛性反复多次解新鲜血便伴中重度贫血.10例病例确诊的患者通过术中辅助肠镜检查,精确定位后,采用点状、楔型和肠段切除.随访1～18个月,再出血1例.结论胶囊式内镜是目前小肠血管畸形较理想的诊断方法.术中辅助肠镜检查,采用点状切除结合楔形和肠段切除是治疗该病较有效的方法.

Objective To evaluate the effect of capsule endoscopic examination in the diagnosis of vascular malformation of small intestine and discuss the operative method of this disease. Methods The clinical data of 11 cases of vascular malformation of small intestine by the capsule endoscopic diagnosis were analyzed retrospectively. Results All of the 11 cases received operation with the assistance of intraoperative endoscopic examination, and 10 cases were confirmed to suffer from vascular malformation of small intestine postoperatively. The methods of operation included dot-resection, wedge-shaped resection and segmental resection. Conclusions The capsule endoscopic examination is optimal for the diagnosis of vascular malformation of small intestine. Dot-resection, wedge-shaped resection and segmental resection with the assistance of intra-operative endoscopic examination for the surgical intervention of this disease are recommendable.