双气囊电子小肠镜在小肠疾病诊断中的作用

Diagnostic Impact of Double-balloon Enteroscopy (DBE) in Small Bowel Diseases

目的评价双气囊电子小肠镜在小肠疾病中的诊断价值。方法对135例拟诊或需排除小肠疾病的患者在静脉麻醉下进行155次小肠镜检查。92例单纯经口进镜,23例单纯经肛门进镜,20例经口和肛门两次进镜。结果小肠疾病的整体检出阳性率为78.52%(106/135)。其中良恶性肿瘤45例,克罗恩病26例,小肠非特异性炎症14例,小肠淋巴管扩张7例,小肠毛细血管畸形6例,过敏性紫癜2例,小肠气囊肿症、肠套叠、回肠憩室、双回肠畸形、小肠息肉和小肠蛔虫症各1例。对小肠出血的检出阳性率为86.84%(33/38)。经口及肛门进镜耗时分别约30和50分钟。结论双气囊电子小肠镜是目前诊断小肠疾病最有效和最准确的方法。

Objective： To prospectively assess the diagnostic impact of double-balloon enteroscopy （DBE） in patients with suspected small bowel disease. Methods： 135 patients referring to our hospital for suspected small bowel disease underwent DBE. Starting insertion route （oral or anal） of DBE was chosen according to the estimated location of the suspected lesions basing on the clinical presentation and on the findings,when available, of previous endoscopic or radiological investigations. Oral and anal route DBE were performed in 92 and 23 patients respectively, while 20 patients underwent a combination of both approaches. Results： 155 DBE procedures were carried out. Overall diagnostic yield of DBE resulted 78.52% （106/135） .Most common pathological findings included tumours （n=45）, Crohn＇s disease （n=26）, non-specific enteric inflammation （n= 14）, lymphangiectasia （n=7）, angiodysplasias （n=6）, allergic purpura （n=2） and intestinal pneumatosis cystoids, intussusception, iliem diverticulosis, double iliem dysplasia, intestinal polyp and ascads （n= 1） individually. The positive rate of DBE for intestinal bleeding is 86.84% （33/38）.It took 30 and 50 minutes on oral and anal insertion route respectively. No major complications related to the procedure occurred. Conclusions： DBE is a useful, safe and well-tolerated new method with a high diagnostic impact for the management of suspected small bowel diseases.