双气囊电子内镜在消化系统疾病中的诊断价值

Evanuation of Double Balloon Endoscopy in the Diagnosis of Gastrointestinal Diseases

目的探讨双气囊电子内镜(DBE)在消化系统(尤其是小肠)疾病中的诊断价值。方法对我院50例DBE检查患者进行临床分析和电话随访。结果50例患者共行65次DBE检查。在所有患者、不明原因消化道出血(OGIB)和腹痛或腹部不适患者中,确诊率分别为84.0%、84.0%和88.2%;DBE检查准确率为90.5%、90.5%和86.7%。对小肠病变的诊断敏感性为94.1%、94.4%和90.0%;特异性为75.0%、66.7%和80.0%;阳性预测值为94.1%、94.4%和90.0%;阴性预测值为75.0%、66.7%和80.0%。不同DBE检查时机患者之间的确诊率(92.3%∶75.0%)和DBE检查准确率(91.7%∶88.9%)均无显著性差异(P>0.05)。结论DBE对小肠疾病具有较好的诊断价值,不同指征患者之间存在差异。DBE检查时机对OGIB的诊断能力无明显影响。

Objective To investigate the diagnostic value of double balloon endoscopy（DBE） in the patients with gastrointestinal diseases（especially with small intestinal diseases）. Methods The clinical data and images form DBE of 50 consecutive patients form 2004 to 2009 in Peking University Third Hospital were analyzed. These patients were followed up by telephone. Results A total of 50 patients underwent 65 DBE procedures. Among all the patients,the onset with obscure gastrointestinal bleeding（OGIB） and abdominal pain or discomfort, the rate of definitive diagnosis was 84. 0% ,84. 0% and 88.2% , respectively. The accuracy of BDE procedure was 90. 5% ,90. 5% and 86.7%. The sensitivity of DBE for small intestinal diseases was 94. 1% ,94.4% and 90. 0%. The specificity was 75.0% ,66. 7% and 80. 0%. The positive predictive value was 94. 1% ,94.4% and 90. 0%. The negative predictive value was 75.0% ,66. 7% and 80. 0%. No difference was found in rate of definitive diagnosis（92.3% ： 75.0% ） and the accuracy of DBE procedure（91.7% ： 88.9% ） between the patients with different examining opportunities（ P 〉 0. 05 ）. Except one acute pancreatitis and aspiration pneumonia, no serious complications related with the DBE procedure occurred. Conclusion DBE with high diagnostic： value and safety was a good method in the diagnosis of small intestinal diseases. There were differences in the diagnostic value among patients with different indications. The DBE examining opportunity had no influence on the diagnostic yield of OGIB.