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电子小肠镜在小肠疾病中的诊断价值 被引量:1

Diagnostic value of electronic enteroscopy in small bowel diseases
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摘要 目的:分析电子小肠镜的适应证、病变检出率、阳性发现和诊断率并与小肠结肠计算机体层成像(computed tomography,CT)双期扫描进行对比,从而探讨电子小肠镜对小肠疾病的诊断价值.方法:回顾性分析我院消化科疑诊为小肠疾病的患者170例,所有患者均行电子小肠镜检查共273例次(经口检查152例次,经肛检查121例次,双侧对接检查103例次).其中,129例患者同时经过了小肠结肠CT双期扫描检查.对比分析小肠镜和CT的适应证、病变检出率及阳性发现,并将小肠镜诊断、CT结果与病理诊断(内镜下活检病理或/和手术病理)进行比较,判断小肠镜和CT的诊断准确率.结果:小肠镜检查适应证中,不明原因消化系出血占60.6%(103/170).炎性病变、息肉或肿瘤以及血管性病变是小肠镜的三大阳性发现.疑患小肠疾病患者中,CT的病变总检出率为63.6%(82/129),整体诊断率为34.1%(44/129);小肠镜的病变总检出率为89.4%(152/170),整体诊断率为67.6%(115/170),均明显高于CT(P<0.05).其中,对于不明原因消化系出血患者,CT的病变检出率为52.6%(41/78),诊断率为21.8%(17/78);小肠镜的病变检出率为95.1%(98/103),诊断率为68.9%(71/103),小肠镜对不明原因消化道出血的病变检出率和诊断率亦高于CT(P<0.05).结论:电子小肠镜对小肠疾病的病变检出和诊断能力均明显优于CT,并且对不明原因消化系出血有相对较高的病变检出率和诊断率,是一种安全高效的小肠疾病检查方法. AIM: To evaluate the diagnostic value of elec- tronic enteroscopy in small bowel diseases by comparing with enterocolonic double phase computed tomography (CT). METHODS: A retrospective analysis of 273 electronic enteroscopy procedures were carried out in 170 patients with suspected small bowel diseases, 129 of whom received enterocolonic double phase CT scan at the same time. The in- dications, detection rate, positive findings, and diagnostic yield of electronic enteroscopy were compared with those of CT. The diagnostic ac-curacy of electronic enteroscopy and CT was determined by comparing with pathological di- agnosls RESULTS: Obscure gastrointestinal bleeding (OGIB) was the most common indication (60.6%, 103/170) for electronic enteroscopy. Inflamma- tory lesions, polyposis or tumors, and vascular lesions made up the first three positive findings of electronic enteroscopy in patients with sus- pected small bowel diseases. The detection rate and diagnostic yield of electronic enteroscopy were higher than those of CT [89.4% (152/170) vs 63.6% (82/129), 67.6% (115/170) vs 34.1% (44/129), both P 〈 0.05]. In patients with OGIB, the detection rate and diagnostic yield of elec- tronic enteroscopy were also higher than those of CT [95.1% (98/103) vs 52.6% (41/78), 68.9% (71/103) vs 21.8% (17/78), both P 〈 0.05]. CONCLUSION: The electronic enteroscopy Suspected OGIB is the diagnostic capacity of is better than that of CT. most common indication for electronic enteroscopy, which has a relatively high detection rate and diagnostic yield. Elec- tronic enteroscopy is a safe and effective diag- nostic modality for small bowel diseases.
出处 《世界华人消化杂志》 CAS 北大核心 2013年第36期4194-4199,共6页 World Chinese Journal of Digestology
关键词 电子小肠镜 计算机体层成像 小肠疾病 诊断 Electronic enteroscopy Computed to-mography Small bowel disease Diagnosis
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