单气囊小肠镜对老年患者小肠疾病诊断的应用

Application of single balloon enteroscopy in diagnosis of small intestinal diseases in elderly patient

目的评价单气囊小肠镜(single balloon enteroscopy,SBE)对老年患者小肠疾病的诊断价值。方法回顾性分析首都医科大学附属北京友谊医院消化分中心2017年1月至2019年12月行全身静脉麻醉SBE检查老年患者60例,与同期检查的146例非老年患者进行比较。结果60例老年患者均能耐受检查,检出阳性率为46.7%(28/60),老年患者SBE检查时间为22~172 min,平均检查时间为76.9 min。老年患者主要受检原因为不明原因消化道出血56.7%(34/60),老年患者因腹痛受检比例16.7%(10/60)显著低于非老年组患者34.2%(50/146)(P=0.018)。老年患者检出主要疾病为小肠肿瘤28.6%(8/28)及血管病变28.6%(8/28),在检出疾病中老年患者小肠炎症、溃疡的发生比例25.0%(7/28)显著低于非老年患者48.4%(30/62)(P=0.037)。老年患者的小肠病变检出率、操作时间、并发症发生率与同期检查的非老年患者相同,差异无统计学意义(P>0.05)。结论SBE对老年患者小肠疾病的诊断是一种安全、可靠的手段。

Objective To evaluate the clinical value of single balloon enteroscopy(SBE)in the diagnosis of small intestinal diseases in elderly patient.Methods A total of 60 elderly patients who underwent SBE under general intravenous anesthesia from Jan.2017 to Dec.2019 in Beijing Friendship Hospital were retrospectively analyzed,and compared with 146 cases of non-elderly patients examined at the same time.Results 60 elderly patients were able to tolerate checks.The positive rate was 46.7%(28/60).The examination time of SBE was from 22 minutes to 172 minutes(mean 76.9 minutes).The main reason of SBE in elderly patients were obscure gastrointestinal bleeding 56.7%(34/60),and the proportion of elderly patients with abdominal pain was 16.7%(10/60),which was significantly lower than that of non-elderly patients 34.2%(50/146)(P=0.018).The main diseases were small intestinal tumor 28.6%(8/28)and vascular disease 28.6%(8/28).The incidence rate of intestinal inflammation and ulcer in elderly patients 25.00%(7/28)was significantly lower than that in non-elderly patients 48.4%(30/62)(P=0.037).There was no significant difference in the detection rate,operation time and complication rate between the two groups(P>0.05).Conclusion SBE is a safe and reliable method for diagnosis of samll intestinal diseases in elderly patient.