气囊辅助小肠镜在小肠疾病诊治中的应用价值

Clinical value of balloon assisted small enteroscopy in the small bowel diseases

目的评价气囊辅助小肠镜在小肠疾病诊断中的应用价值。方法收集2011年1月-2016年1月在陆军总医院进行气囊辅助小肠镜检查的396例次患者的临床资料及小肠镜诊治资料进行回顾性分析。结果 294例患者共接受396次小肠镜检查。总体疾病检出率为64.97%,可疑小肠出血者109例,占全部受检者的37.07%。在可疑小肠出血患者中,血管发育异常、间质瘤、Meckl憩室及克罗恩病分别占19.27%、14.68%、13.76%及13.76%。75.86%的小肠克罗恩病累及回肠。小肠镜术中牵拉后解除外科术后小肠粘连性肠梗阻10例,有效率83.33%。小肠镜下治疗率28.23%。总体并发症发生率0.51%,主要为息肉切除术后穿孔。结论气囊辅助小肠镜检查是小肠疾病诊断及治疗的安全可靠方法,是可疑小肠出血的重要检查手段。小肠镜是解除外科术后小肠粘连的重要方法。

Objective To evaluate the clinical value of balloon assisted small enteroscopy （BE） in the small bowel diseases. Methods The clinical and endoscopic data of 396 cases from Jan. 2011 to Jan. 2016 in PLA Army General Hospital were analyzed respectively. Results Three hundred and ninety-six small bowel endoscopy examinations was performed in 294 patients. The overall disease detection rate was 64.97%. One hundred and nine cases were suspected small intestinal bleeding and they accounted for 37.07% of all the subjects. Vascular dysplasia were 19.27% , stromal tumor, Meckl diverticulum and Crohn＇ s disease were 14.68% , 13.76% and 13.76% respectively in patients with suspected small intestinal bleeding. 75.86% of Crohn＇ s disease involved the ileum. Ten patients with postoperative intestinal adhesion were relieved by pulling in the small bowel endoscopy and the total effective rate reached 83.33%. Endoscopic treatment rate was 28.23 %. The overall complication rate was 0.51% and most of them were perforation after resection of the polyp. Conclusion Balloon assisted small bowel endoscopy is a safe and efficient toolin the diagnosis and treatment of small bowel diseases. BE is an important method to remove small bowel adhesion after surgical operation.