双气囊小肠镜对小肠疾病的诊断价值及安全性分析

Diagnostic value and safety of dual balloon enteroscopy in small intestinal diseases

目的探讨双气囊小肠镜(DBE)对小肠疾病的诊断价值及安全性分析。方法回顾性分析2014年1月至2018年5月深圳市龙华区人民医院内镜中心经DBE检查的85例小肠疾病患者的临床资料。结果共发现67例病变,病变检出率78.8%,发现病因病变65例,诊断阳性率为76.5%。以慢性腹痛为主要临床表现的阳性疾病检出率为71.4%(30/42),其中克罗恩病(CD)最高,占到60%(18/30);不明原因小肠出血为主要临床表现的阳性疾病检出率为82.9%(30/35),其中Meckal憩室最高,占到46.7%(14/30);小肠不全梗阻为主要临床表现的阳性疾病检出率为60%(3/5),其中CD最高,占到66.7%(2/3)。检查中有2例DBE外套管与镜身对肠黏膜造成数个切割样损伤,未造成活动性出血、穿孔等并发症,其余患者无胃肠穿孔、黏膜撕裂、出血及急性胰腺炎等并发症出现。结论 DBE检查成功率高,对小肠疾病有很高的敏感性和特异性,操作安全可靠,为目前诊治小肠疾病的理想方法,值得临床推广。

Objective To evaluate the diagnostic value and safety of double balloon enteroscopy(DBE) in small intestinal diseases.Methods The clinical data of 85 cases of small intestinal diseases examined by DBE in the endoscopic center of people’s hospitalof longhua district, shenzhen city from January 2014 to May 2018 were analyzed retrospectively. Results A total of 67 lesions werefound in 85 patients, with a detection rate of 78.8%. 65 etiological lesions were found, with a diagnosis rate of 76.5%. The detection rateof chronic abdominal pain as the main clinical manifestation was 71.4%(30/42), among which Crohn’s disease(CD) was the highest,accounting for 60%(18/30). The detection rate of small intestinal bleeding with unknown cause was 82.9%(30/35), and Meckaldiverticulum was the highest, accounting for 46.7%(14/30). The detection rate of small intestinal incomplete infarction was 60%(3/5),among which CD was the highest, accounting for 66.7%(2/3). After examination, there were a number of cutting samples in smallintestinal mucosa caused by lens barrel in 2 patients, caused no complications such as hemorrhage, perforation. No gastrointestinalperforation, mucosal tear, bleeding or acute pancreatitis were found in the remaining patients. Conclusion DBE has high success rateand high sensitivity and specificity to small intestinal diseases. And it is safe and reliable. It is an ideal method for diagnosis and treatmentof small intestinal diseases.