双气囊小肠镜对小肠疾病诊断与治疗的应用体会

Diagnostic value and therapic safety of double-balloon enteroscopy in small bowel diseases

目的:探讨双气囊电子镜在小肠疾病诊断价值和治疗的安全性。方法:对110例疑似小肠疾病患者均采用静脉麻醉下进行双气囊电子镜检查,记录检查阳性率、诊断结果及并发症等情况。结果:110例患者共确诊91例,阳性率:82.7%(91/110);不明原因的小肠出血70例,占85.4%(70/82)。其中克罗恩病25例,占病例总数的22.7%,小肠间质瘤13例(11.8%),发现1例间质瘤恶变,小肠癌6例(5.5%),血管疾病共11例(10.0%),多发性溃疡12例(10.9%),非特异性炎症例9例(8.2%),小肠息肉5例(4.6%),肠结核2例(1.8%),小肠憩室2例(1.8%),小肠淋巴滤泡增生2例(1.8%),小肠脂肪瘤2例(1.8%),空肠黏膜缺损1例(0.9%),十二指肠乳头癌1例(0.9%)。3例血管疾病患者进行了止血治疗。对4例小肠息肉患者进行了镜下切除及行APC治疗。24例患者进行了全胃肠检查,患者可以很好的耐受检查。结论:双气囊电子镜能够安全地检查全小肠及诊断各种疾病,并能安全有效地进行内镜下治疗。

Objective ： To assess the diagnostic value and therapic safety of double - balloon enteroscopy （DBE） to observe the intestine directly. Methods：All 110 patients were detected by DBE,sedatives were used by all the pa- tients before the examination. Results ：The positive rate of the examination was 82.7% （91/110）, intestinal bleeding with obscure reasons 85.4% （70/82） was the main indications for this examination, Crohn＇s disease 25 （ 22.7% ）, small bowel stromal tumors 13（ 11.8%, malignant cells were found in 1 ）, malignant tumors 6（5.5% ）, vascular le- sions 11 （ 10.0% ）, small intestinal ulcer 12 （ 10.9% ）, non - specfic enteric inflammation 9 （ 8.2% ）, small intestinal poylp 5 （4.6%）, intestinal tuberculosis 2 （ 1.8% ）, small bowel diverticulosis 2 （ 1.8% ）, intestinal lymphoid folicle proliferation 2 （ 1.8 % ）, intestinal lipomyoma 2 （ 1.8 % ）, jejunum mucosa coloboma disease 1 （0.9%）, duodenal pa- pilla cancer 1 （0.9%）. 3 patients of intestinal vascular lesions patients were treated with hemostasis. 4 patients of in- testinal poylp were resected and accepted APC in endoscopy. The entire small bowel was completely explored in 24 patients. The patients could endure the examination with the help of sedatives. Most of the patients with tumor or bowel inflammations had the pathological diagnosis. Conclusion： DBE could observe the whole intestine and diagnose the diseases with a high safety. It is a safe and effective method for treatment of small bowel diseases.