胶囊内镜序贯联合双气囊小肠镜诊断小肠出血

目的评价胶囊内镜(capsule endoscopy,CE)序贯联合双气囊小肠镜(double-balloon enteroscopy,DBE)检查对小肠出血疾病(small intestine bleeding,SIB)的临床诊断价值。方法回顾性分析106例行CE检查及部分序贯联合DBE检查SIB患者的临床资料。结果 106例SIB患者病因明确诊断率为96.2%(102/106),以肠黏膜糜烂、溃疡性病变25.5%(27/106)、血管病变24.5%(26/106)、小肠肿瘤、隆起病变23.6%(25/106)最常见;行CE和DBE检查的病变检出率分别为89.6%(95/106)、96.2%(50/52),病因诊断率分别为50.9%(54/106)、92.3%(48/52),DBE检查病因诊断率显著高于CE检查,差异有统计学意义(P0.01);CE和DBE检查发现血管病变、肿瘤隆起病变与憩室分别为22.6%(24/106)、0.9%(1/106)和51.9%(27/52)、15.4%(8/52),DBE对血管病变、肿瘤隆起病变与憩室病因的诊断率高于CE,二者比较差异有统计学意义(P0.05)。结论在小肠出血患者中CE检查对血管病变、肿瘤隆起病变与憩室的病因诊断低于DBE检查;CE序贯联合DBE检查应用能提高小肠出血疾病的病变检出率及病因诊断率。

Clinical analysis of capsule endoscopy combined with double-balloon enteroscopy for diagnosis of small ;intestinal bleeding

Objective To investigate the diagnostic value of capsule endoscopy（CE） sequentially com-bined with double-balloon enteroscopy （DBE） in patients with small intestinal bleeding （SIB） and to guide the reasonable application of capsule endoscopy and double-balloon enteroscopy. Methods The clinical data of 106 patients with suspected SIB underwent CE and part of the patient who sequentially underwent DBE exam-ination were retrospectively analyzed. Results Etiological diagnostic accuracy in 106 patients with suspected SIB was 96.2%（102/106）. It was found that the intestinal mucosal erosions and ulcerations, vascular disease, small bowel tumors were the most common, consisting of 25.5%（27/106）, 24.5%（26/106）, 23.6%（25/106）, respectively. The detective rates of CE and DBE were 89.6%（95/106） and 96.2%（50/52）, and their diagnostic accuracy rates were 50.9%（54/106） and 92.3%（48/52）, respectively, and DBE was superior to CE in the etio-logical diagnosis of SIB （P〈0.01）. The detective rates for vascular and tumorous or diverticular disease were 20.6%（22/106）, 0.9%（1/106） by CE, and 50.0%（26/52）, 15.4%（8/52） by DBE, respectively. DBE was supe-rior to CE in diagnosing vascular, tumorous and diverticular disease （P〈0.05）. Conclusions DBE was superi-or to CE in fingding the vascular, tumorous, and diverticular disease in patients with SIB. CE sequentially combined with DBE could increase the detective rate and diagnostic accuracy.