双气囊小肠镜在青少年小肠憩室出血中的诊断价值

The diagnostic value of double-balloon enteroscopy in the adolescent patients with small intestinal diverticulum hemorrhage

目的探讨双气囊小肠镜(double-balloon enteroscopy,DBE)在青少年小肠憩室出血中的诊断价值。方法回顾性分析2007年7月-2015年9月武汉大学人民医院消化内镜中心行DBE检查并诊断为小肠憩室出血的37例青少年患者病历资料。结果DBE检出37例小肠憩室出血患者,其中少年组7例(男4例,女3例),青年组30例(男28例,女2例),组间性别构成比差异有统计学意义(P<0.05);患者主要首发症状表现为便血、黑便,其中便血13例(35.14%)、黑便24例(64.86%),差异有统计学意义(P<0.01);憩室部位主要包括十二指肠憩室1例(2.70%)、空回肠憩室34例(91.89%)、Meckel憩室2例(5.41%),患者小肠憩室部位分布差异有显著统计学意义(P<0.01);有7例小肠憩室出血患者行切除手术治愈,术中憩室位置与DBE确定位置一致,随访无复发;所有患者行DBE检查均未出现明显不良反应和严重并发症。结论 DBE不仅能有效诊断青少年小肠憩室出血,还能为外科手术提供可靠依据,且安全性较高。

Objective To evaluate the diagnostic value of double-balloon enteroscopy（ DBE） in adolescent patients with small intestinal diverticulum hemorrhage. Methods This retrospective review was carried out on the data of 37 patients with small intestinal diverticulum hemorrhage who received DBE from Jul. 2007 to Sep. 2015 in Renmin Hospital of Wuhan University. Results Thirty-seven patients were divided into the adolescent group and the adult group. Sex difference had statistical significance between groups（ P〈0. 05）. The main clinical symptoms were hematochezia and melena,there were 13 cases of hematochezia（ 35. 14%） and 24 cases of melena（ 64. 86%）,difference had statistical significance（ P〈0. 01）. One case of duodenal diverticulum,34 cases of jejunoileal diverticulum,2 cases of Meckel diverticulum were diagnosed among 37 cases of DBE examination,the distribution of small intestinal diverticulum had statistical significance（ P〈0. 01）. Seven cases of small intestinal diverticulum were cured by diverticulectomy,without recurrence in the following periods. Diverticular positions determined by surgery were consistent with the finding by DBE. No procedure-related severe adverse events or severe complications occurred in all cases. Conclusion DBE examination with higher safety can not only efficiently diagnose the adolescent with small intestinal diverticulum hemorrhage,but also can provide a reliable basis for surgical operation.