小肠镜在小肠出血诊断中的应用探讨

回顾性分析62例小肠出血行小肠镜检查患者的临床资料，分为镜检阳性病变检出组（50例）及阴性检出组（12例），进行临床特征比较。结果显示，阳性病变检出组中75．0％（21／28）的黑便患者经肛侧进镜检出病变，81．8％（18／22）的鲜血便患者经肛侧进镜检出病变（P〈0．01）。阳性病变检出组较阴性检出组病程长，出血次数多，末次出血至小肠镜检查的时间短（P〈0．01或P〈0．05）。出血次数≥3次者阳性检出率显著高于出血次数〈3次者（92．5％比11．1％，P〈0．01）。末次出血后7d内行小肠镜检查阳性检出率明显高于7d后检查者（97．1％比59．3％，P〈0．01）。

Diagnosis of small bowel bleeding with double balloon endoscopy

Sixty two patients with small bowel bleeding underwent double balloon endoscopy （DBE）. Clinical features were compared between patients with positive DBE findings （50 cases） and those with negative findings （ 12 cases）. Results revealed that the causes of melena were discovered in 75.0% （21/28） patients via oral approach, while the lesions were found in 81.8% （18/22） patients with hematochezia via anal approach （P 〈 0.01 ）. Duration of bleeding was longer and number of bleeding episodes was higher in patients with positive DBE findings than those with negative findings （ P 〈 O. 05 or P 〈0. 01 ）. The time interval between the latest bleeding and DBE was significantly shorter in patients with positive DBE findings （ P 〈 0.05 ）. Positive diagnostic rate was significantly higher in patients with three or more bleeding episodes than those less than three times （92. 5 % vs. 11.1% , P 〈 O. 01 ）. DBE performed within seven days or less increased the positive diagnostic rate significantly than that after seven days （97.1% vs. 59.3%,P〈0.01）.