单气囊小肠镜对可疑小肠疾病诊疗价值的探讨

Diagnostic and Therapeutic Value of Single-balloon Enteroscopy in Suspected Small Intestinal Diseases

背景:单气囊小肠镜(SBE)作为一种较新的小肠检查手段,在可疑小肠疾病中的临床价值需进一步探讨。目的:评价SBE在可疑小肠疾病诊疗中的价值。方法:回顾性总结2011年7月-2013年10月成都军区总医院接受SBE检查的73例患者共81例次检查的资料,分析SBE的适应证以及对可疑小肠疾病的诊断和治疗效果。结果:81例次SBE检查中,不明原因消化道出血33例次(40.7%),不全性肠梗阻29例次(35.8%),慢性腹痛或腹泻19例次(23.5%)。SBE经口插镜深度平均为230 cm,经肛平均为100 cm。SBE的阳性诊断率为67.9%,检出病变主要包括小肠溃疡、小肠炎症、小肠肿瘤和小肠息肉等。镜下治疗8例,其中止血治疗5例,息肉切除3例。无严重并发症发生。结论:SBE是可疑小肠疾病的有效诊疗手段,其主要适应证为不明原因消化道出血和不全性肠梗阻。

Background：Single-balloon enteroscopy（SBE）is a new method for the examination of small intestine,its clinical value in suspected small intestinal diseases need to be further studied. Aims：To evaluate the diagnostic and therapeutic value of SBE in suspected small intestinal diseases. Methods：A total of 73 suspected small intestinal diseases patients who had undergone 81 SBE examinations from July 2011 to October 2013 at Chengdu Military General Hospital were retrospectively examined,indications,diagnostic and therapeutic value of SBE in suspected small intestinal diseases were analyzed. Results：Of all the 81 examinations,33（40. 7% ）were obscure gastrointestinal bleeding,29（35. 8% ） incomplete intestinal obstruction,and 19（23. 5% ）chronic abdominal pain or diarrhea. The intubation depth was 230 cm for the oral approach,and 100 cm for the anal approach. The diagnostic yield of SBE was 67. 9% ,the main lesions were small intestinal ulcer,small intestinal inflammation,small intestinal tumor,small intestinal polyp. A total of 8 patients underwent endoscopic therapy,of whom 5 underwent endoscopic hemostatic therapy and 3 underwent resection of polyp. No serious complications were found. Conclusions：SBE is a safe and reliable diagnostic and therapeutic method for suspected small intestinal diseases,and its main indications are obscure gastrointestinal bleeding and incomplete intestinal obstruction.