Background and study aims: Until recently, only the proximal small bowel was accessible for diagnostic and therapeutic endoscopy. This paper describes experience in the first 275 patients examined and treated with the...Background and study aims: Until recently, only the proximal small bowel was accessible for diagnostic and therapeutic endoscopy. This paper describes experience in the first 275 patients examined and treated with the new method of double-balloon enteroscopy (DBE), which is expected to make full-length enteroscopy possible. Patients and methods: Between November 2003 and May 2005, double-balloon enteroscopy was conducted in 275 consecutive patients presenting at two tertiary referral hospitals. The characteristics of the patients, indications for the procedures, procedural parameters, and diagnostic yield are described here. All conventional treatment options were available. The tolerability of the procedure was assessed in a small subset of the patients. After the procedure, the patients were monitored in a recovery room for at least 2 h. They were discharged afterwards, provided there were no signs of complications or complaints. Results: The main indication for DBE was suspected small-bowel bleeding (n = 168), and the lesions responsible for the bleeding were found in 123 patients (73 % ) and treated in 61 (55 % ). In patients with refractory celiac disease (n = 25), DBE revealed a high proportion (six patients, 23% ) of enteropathy-associated T-cell lymphomas that had not been suspected on other tests. Further DBE indications were surveillance and treatment of hereditary polyposis syndromes (n = 20); and suspected Crohn’ s disease, which was diagnosed with DBE in four of 13 patients (30 % ). No relevant pathology was found in 24% of the patients. Panenteroscopy was successfully performed in 26 of 62 patients (42% ) in whom it was attempted, in either one or two sessions. The average duration of the procedures was 90 min (range 30-180 min, SD 42), and the average insertion length was 270 cm (range 60-600 cm, SD 104). Patients’ tolerance of the procedure was excellent. Severe complications were recognized in three cases (1 % ), all involving pancreatitis. Conclusions: This large pilot series shows that DBE is a well-tolerated and safe new endoscopic technique with a high diagnostic yield in selected patients.展开更多
目的探讨尿微量白蛋白/肌酐(mAlb/ucr)比值在妊娠期高血压疾病患者早期肾损伤诊断中的应用价值。方法选取2019年3月-2021年4月在三明市第二医院产科就诊的妊娠期高血压疾病患者109例作为观察组,其中妊娠期高血压组60例、轻度子痫前期组3...目的探讨尿微量白蛋白/肌酐(mAlb/ucr)比值在妊娠期高血压疾病患者早期肾损伤诊断中的应用价值。方法选取2019年3月-2021年4月在三明市第二医院产科就诊的妊娠期高血压疾病患者109例作为观察组,其中妊娠期高血压组60例、轻度子痫前期组35例、重度子痫前期组14例,将产检正常的妊娠妇女50例作为对照组。分别测定各患者组及对照组的mAlb/ucr比值、24 h尿蛋白定量(24 h UTP),记录并分析结果。结果mAlb/ucr比值、24 h UTP妊娠期高血压组、轻度子痫前期组及重度子痫前期组与对照组比较均显著升高,差异有统计学意义(P<0.05);妊娠期高血压组、轻度子痫前期组及重度子痫前期组3组之间两两比较,差异均有统计学意义(P<0.05)。随着病情的发展,mAlb/ucr比值、24 h UTP逐渐升高,妊娠期高血压疾病患者mAlb/ucr比值与24 h UTP具有高度正相关性(P<0.05)。结论妊娠期高血压疾病患者早期肾损伤时mAlb/ucr与24 h UTP即可升高,并且与病情严重程度密切相关,检测mAlb/ucr对妊娠期高血压疾病患者早期肾损伤具有重要的临床诊断价值。展开更多
文摘Background and study aims: Until recently, only the proximal small bowel was accessible for diagnostic and therapeutic endoscopy. This paper describes experience in the first 275 patients examined and treated with the new method of double-balloon enteroscopy (DBE), which is expected to make full-length enteroscopy possible. Patients and methods: Between November 2003 and May 2005, double-balloon enteroscopy was conducted in 275 consecutive patients presenting at two tertiary referral hospitals. The characteristics of the patients, indications for the procedures, procedural parameters, and diagnostic yield are described here. All conventional treatment options were available. The tolerability of the procedure was assessed in a small subset of the patients. After the procedure, the patients were monitored in a recovery room for at least 2 h. They were discharged afterwards, provided there were no signs of complications or complaints. Results: The main indication for DBE was suspected small-bowel bleeding (n = 168), and the lesions responsible for the bleeding were found in 123 patients (73 % ) and treated in 61 (55 % ). In patients with refractory celiac disease (n = 25), DBE revealed a high proportion (six patients, 23% ) of enteropathy-associated T-cell lymphomas that had not been suspected on other tests. Further DBE indications were surveillance and treatment of hereditary polyposis syndromes (n = 20); and suspected Crohn’ s disease, which was diagnosed with DBE in four of 13 patients (30 % ). No relevant pathology was found in 24% of the patients. Panenteroscopy was successfully performed in 26 of 62 patients (42% ) in whom it was attempted, in either one or two sessions. The average duration of the procedures was 90 min (range 30-180 min, SD 42), and the average insertion length was 270 cm (range 60-600 cm, SD 104). Patients’ tolerance of the procedure was excellent. Severe complications were recognized in three cases (1 % ), all involving pancreatitis. Conclusions: This large pilot series shows that DBE is a well-tolerated and safe new endoscopic technique with a high diagnostic yield in selected patients.
文摘目的探讨尿微量白蛋白/肌酐(mAlb/ucr)比值在妊娠期高血压疾病患者早期肾损伤诊断中的应用价值。方法选取2019年3月-2021年4月在三明市第二医院产科就诊的妊娠期高血压疾病患者109例作为观察组,其中妊娠期高血压组60例、轻度子痫前期组35例、重度子痫前期组14例,将产检正常的妊娠妇女50例作为对照组。分别测定各患者组及对照组的mAlb/ucr比值、24 h尿蛋白定量(24 h UTP),记录并分析结果。结果mAlb/ucr比值、24 h UTP妊娠期高血压组、轻度子痫前期组及重度子痫前期组与对照组比较均显著升高,差异有统计学意义(P<0.05);妊娠期高血压组、轻度子痫前期组及重度子痫前期组3组之间两两比较,差异均有统计学意义(P<0.05)。随着病情的发展,mAlb/ucr比值、24 h UTP逐渐升高,妊娠期高血压疾病患者mAlb/ucr比值与24 h UTP具有高度正相关性(P<0.05)。结论妊娠期高血压疾病患者早期肾损伤时mAlb/ucr与24 h UTP即可升高,并且与病情严重程度密切相关,检测mAlb/ucr对妊娠期高血压疾病患者早期肾损伤具有重要的临床诊断价值。
