双气囊小肠镜在小肠出血中的应用价值

The Application of Double Balloon Endoscopy in Small Intestinal Bleeding

目的:观察双气囊小肠镜在小肠出血中的病变检出率、病因诊断率、耐受性和安全性,并探讨双气囊小肠镜对小肠出血的内镜下治疗。方法:对2006年3月至2009年11月烟台毓璜顶医院消化内科收治的可疑小肠出血102例患者双气囊小肠镜检查,首选进镜方式分为经口或经肛2种,首选方式检查后未发现病灶者,日后改换进镜方式再行检查。对活动性出血病灶行内镜下止血治疗。结果:双气囊小肠镜的病变检出率为94.12%(96/102),病因诊断率为84.31%(86/102),其中35例检查时见病变活动性出血,行内镜下止血治疗,33例止血成功,内镜止血成功率为94.30%(33/35);在耐受性方面,双气囊小肠镜的耐受性依次为:全麻下经肛进镜、全麻下经口进镜、非麻醉经肛进镜、非麻醉经口进镜。所有患者均未发生严重并发症。结论:双气囊小肠镜对小肠出血具有较高的病变检出率和病因诊断率,并且可行内镜下止血治疗,是一项安全、有效的临床诊疗方法。

Objective：To observe the diagnostic yield,accuracy of etiological diagnosis,toleration and safety of double balloon enteroscopy in patients with small intestine bleeding.And to explore the endoscopic therapy of double balloon enteroscopy for small intestine bleeding.Methods：One hundred and two patients with small intestine bleeding in Department of Gastroenterology of Yantai Yuhuangding Hospital from March,2006 to Novenber,2009 were performed double balloon enteroscopy.The route of enteroscopy could be underwent either via mouth or via anus.Negative result of initial route was required afterwards for another via mouth or via anus examination.For active small intestinal bleeding detected during examination,endoscopic hemostasis was done to treat bleeding.Results： The overall diagnostic yield for double balloon enteroscopy was 94.12%（96/102）,and The etiological diagnostic accuracy was 84.31% （86/102）.Active bleedings were detected in 35 cases,endoscopic hemostasis was made,bleeding was controlled in 33 cases,the endoscopic hemostasis rate was94.30%（33/35）.On assessment of procedure tolerance,toleration of double balloon enteroscopy was in turn under anaesthesia via anus,under anaesthesia via mouth,via anus without anaesthesia and via mouth without anaesthesia.No serious complications occurred in all the patients.Conclusions：Double balloon enteroscopy is superior to in the diagnosis of small intestinal bleeding and endoscopic hemostasis could be done to treat bleeding by it.Double balloon enteroscopy could be served as one safe and effective method in diagnosis and therapy of obscure small bowel bleeding.