双气囊小肠镜用于青少年患者小肠疾病诊治的安全性评价

Evaluation of application safety of double balloon enteroscopy in pediatric and adolescent patients

目的评估双气囊小肠镜(DBE)对疑似患有小肠疾病的青少年患者诊治的安全性和有效性。方法连续选择我院15例疑似小肠疾病的青少年患者进行DBE检查,其中临床证实或怀疑为Peutz-Jeghers综合征4例,不明原因反复消化道出血待查4例,腹泻待查2例,慢性腹痛待查4例,反复发作不完全性肠梗阻1例。结果所有病例均成功插入小肠,经口检查5例,经肛检查2例,分别经口和经肛检查8例,其中5例进行了全小肠检查,平均插入小肠长度经口和经肛分别为(224.54±78.56)cm和(145.43±75.65)cm;经口插入平均操作时间(95.5±23.2)min,经肛插入平均操作时间(154.6±32.6)min,没有出现明显并发症。15例中发现小肠疾病12例,检出率为80.0%,其中Peutz-Jeghers综合征4例,十二指肠绒毛状管状腺瘤1例,小肠血管瘤1例,小肠多发性毛细血管扩张症1例,空回肠憩室1例,克罗恩病2例,钩虫病1例,Cowden综合征1例。在检出病变的12例中,6例成功进行了DBE治疗。结论 DBE检查和治疗对青少年患者安全可行,具有较好的诊疗价值。

Objective To assess the safety and effectiveness of double balloon enteroscopy（DBE） in the treatment of children with suspicious small bowel disorders. Methods Fifteen children and adolescents suspected of small bowel diseases were selected to take the DBE examination, in which there were 4 cases identified or suspected of Peutz-Jeghers syndrome（PJS）, 4 of obscure gastrointestinal（GI） bleeding, 2 of chronic diarrhea, 4 of chronic abdominal pain, and 1 of recurrent partial bowel obstruction.Results All the cases were successfully inserted into the small intestines, in which there were 5 cases examined via the oral route, 2via the anus, and 8 via both oral route and the anus. Five cases received the examination for entire small bowel. The mean inserted lengths were（224.54±78.56） cm for the oral route and（145.43±75.65） cm for the anal route. The average operative time for the oral route was（95.5 ±23.2） min, and that for the anal route was（154.6 ±32.6） min. No obvious complications occurred. Among the 15 patients, small intestinal diseases were detected in 12 cases with the detection rate of 80.0%, in which there were 4 cases of PJS, one of tubulo-villous adenoma of the duodenum, one of small intestinal angioma, one of multiple telangiectasia of small bowel, one of jejunoileum diverticulum, one of Crohn＇s disease, one of ancylostomiasis, and one of Cowden＇s syndrome. Among the 12 cases, 6 ones achieved therapeutic success of DBE. Conclusion The examination and treatment by DBE are safe for pediatric and adolescent patients and has good value.