双气囊小肠镜与小肠钡灌在小肠疾病诊断中的对比研究

A comparative study between double-balloon enteroscopy and small bowel enteroclysis in the diagnosis of small bowel diseases

目的:比较双气囊小肠镜(double-balloonenteroscopy,DBE)与小肠稀钡灌注在小肠疾病诊断中的检出率以及对小肠基本病变的病因诊断准确率,评估2种检查方法在小肠疾病诊断中的临床实用价值。方法:对130例经常规检查无异常发现、但仍疑为小肠疾病的患者进行研究,所有患者分别行DBE和插管式小肠稀钡灌注检查。结果:130例患者中,DBE对小肠病变的整体检出率为72.3%(94/130例);小肠钡灌为60.0%(78/130例)。DBE的病因诊断准确率高于小肠钡灌。结论:DBE通过经口腔和经肛门两种进镜方式结合,能完成对全小肠检查;小肠稀钡灌注法对小肠肠腔内占位性病变、狭窄性病变、以及结构性病变有一定的定位、定性诊断价值;小肠稀钡灌注法可作为DBE检查前筛选性检查,对小肠镜进镜方式选择提供有效的帮助;DBE对小肠疾病诊断准确性优于小肠稀钡灌注法。

Objective To compare the diagnostic yield and the accuracy of double-balloon enteroscopy with those of small bowel enteroclysis in the patients with suspected small bowel diseases. Methods One hundred and thirty cases of suspected small bowel diseases, who had negative findings through routine diagnostic modalities, were enrolled in the study. All the patients received double-balloon enteroscopy and small bowel enteroclysis with intubation method. Results The overall diagnostic yield for double-balloon enteroscopy was 72.3% （94/130）, and that for small bowel enteroclysis was 60.0% （78/130）. The etiological diagnostic accuracy of double-balloon enteroscopy was 92.6% （87/94）, and that of small bowel enteroclysis was 51.1% （48/94）. Conclusions The entire small bowel could be examined by double-balloon enteroscopy with the combination of oral and anal routes. The etiological diagnostic accuracy of double-balloon enteroscopy is superior to small bowel enteroclysis. Enteroclysis enterography is valuable for detection of small bowel stricture and occupying lesions. Small bowel enteroclysis may he served as a useful screening test for determination of the route of double-balloon enteroscopy procedure. Double-balloon enteroscopy is a safe diagnostic technique with high diagnostic yield and high accuracy for various small bowel diseases.