胶囊内镜指导双气囊内镜进镜方式的临床研究

目的评估小肠疾病诊治中胶囊内镜（CE）对双气囊内镜（DBE）进镜方式的预测作用。方法将CE完成全小肠检查且其诊断经DBE证实者纳入研究。CE检出病灶的部位以时间指数（胶囊从幽门至病灶的通过时间占胶囊从幽门至回盲瓣通过时间的比例）表示，根据以往回顾性分析的结果采用0．6作为时间指数的临界值，时间指数不超过0．6时选择经口DBE检查，反之选择经肛检查。对最终结果进行统计学分析，评估根据病灶部位cE时间指数选择DBE进镜方式的准确性。结果最终共60例患者CE完成全小肠检查且其诊断经DBE证实而纳入研究。共行60例次DBE检查，包括41例经口和19例经肛检查，所有患者CE检出病灶均经首次DBE检查证实。对所得结果进行统计显示，根据cE时间指数临界值0．6，本组患者DBE进镜方式选择的准确性为100％。结论DBE是一项有效地证实CE诊断的方法，在cE完成全小肠检查者中根据CE时间指数能够准确判断DBE的进镜方式。

Guiding value of capsule endoscopy for access route of double-balloon endoscopy

Objective To evaluate the guiding role of capsule endoscopy (CE) in choosing the access route of double-balloon enteroscopy (DBE) for small bowel diseases. Methods Patients with complete CE and with small bowel diseases confirmed by DBE were enrolled. The lesion location found on CE was represented by the time index, which was the ratio of access time from pylorus to lesion over access time from pylorus to ileocecal valve. Based on our previous retrospective evaluation, oral approach was selected when the index was ≤0. 6, otherwise the anal access would be chosen. Accuracy of time index predicting DBE access rout was evaluated. Results Data of 60 patients undergoing both CE and DBE were evaluated. All lesions detected by CE were confirmed by DBE, with 41 via oral route and 19 via anus. Based on the time index with threshold of 0.6, the accuracy of selecting the insertion route of DBE was 100%. Conclusion DBE is an effective approach to confirm CE results. In patients with complete small bowel investigation by CE, the insertion route for DBE can be reliably indicated with time index based on the CE results.