气囊辅助小肠镜治疗Peutz-Jeghers综合征小肠息肉肠套叠的临床探讨 #br#

摘要：目的 评估气囊辅助小肠镜（BAE）治疗Peutz-Jeghers综合征小肠息肉（PJP）肠套叠的有效性及安全性，探 讨影响PJP肠套叠治疗方式选择的因素。方法 收集2013年1月—2019年6月就诊于空军特色医学中心的PJP肠套 叠患者的临床资料，按照纳入、排除标准，最终48例符合要求的患者入选，男女比例为28∶20，平均年龄（20.6±9.2）岁， 统计 PJP肠套叠患者 BAE的治疗成功率、术后并发症发生率，并应用病例对照研究的方法，比较 BAE治疗成功组与 最终外科手术治疗组患者的年龄、性别、外科手术史、临床症状、套叠息肉直径、套叠数量、最长单个套叠长度等临床 资料。结果 BAE治疗 PJP肠套叠的总体有效率为 83.3%（35/42），术后并发症发生率为 2.4%（1/42）。将 35例 BAE 治疗成功者归为小肠镜组，将13例接受外科手术治疗者归为外科组，2组性别、手术史、PJS家族史、导致肠套叠的息 肉平均直径及术中发现息肉数量比较差异均无统计学意义，小肠镜组平均年龄小于外科组、临床症状无或轻者比例 高于外科组，套叠数量少于外科组，套叠长度短于外科组，差异均有统计学意义（P＜0.05或 P＜0.01）。结论 BAE 治疗PJP肠套叠总体安全、有效，可作为PJP肠套叠且不伴完全性肠梗阻患者的首选治疗方案。

Study of balloon-assisted enteroscopy in treating Peutz-Jeghers syndrome polyp with intussusception #br#

Abstract: Objective To assess therapeutic efficacy and safety of balloon assisted enteroscopy (BAE) for treatment of Peutz-Jeghers polyps (PJP) with intussusceptions, and to explore the critical factors that affect the choice of treatment for PJP with intussusception. Methods The clinical data of patients identified as PJP intussusception were collected at the Air Force Medical Center from January 2013 to June 2019. Forty-eight patients were finally enrolled according to the inclusion and exclusion criteria. The ration of male to female was 28∶20, and the mean age was (20.6±9.2) years old. The success rate, the incidence of complications and other clinical data,such as age, gender, history of surgeries, clinical symptoms, diameter of lead polyps, the number of intussusceptions, and the longest length of single intussusception were analyzed. Case control study was performed to compare the different indexes between patients in pure enteroscopic treatment group and surgical treatment group. Results The overall effective rate of BAE treatment of PJP with intussusception was 83.3% (35/42), and the postoperative complication rate was 2.4% (1/42). Thirty-five patients that were treated successfully by BAE were classified as the BAE group, and 13 patients treated with surgery were classified as surgery group. There were no statistically significant differences in gender, history of surgeries, positive rate of PJS family history, average diameter of lead polyps and number of intraoperative polyps between the two groups. The average age was smaller in BAE group than that in surgery group. The proportion of patients with no or mild clinical symptoms was higher in the BAE group than that in surgery group. The number of intussusception was less in the BAE group than that in surgery group, and the longest length of single intussusception was shorter than that in surgery group (P＜0.05). Conclusion BAE is safe and effective in the management of PJP with intussusception, which can be used as the first-line treatment for PJP with intussusception coinciding incomplete intestinal obstruction.