双球囊推进式电子小肠镜操作护理配合

目的:通过对不明原因小肠疾病患者行双球囊推进式电子小肠镜检查,评价其操作性能及安全性以及护理要点。方法:2 0 0 3年7月至2 0 0 4年3月期间38例有消化道症状,经胃镜、结肠镜、全消化道钡餐、腹部血管造影等检查无阳性发现的患者应用双球囊推进式电子小肠镜检查,视患者病情决定从上消化道或下消化道进镜,其中8例经上消化道进镜未能达到回盲部改从下消化道进镜。结果:小肠镜检查发现有病变者33例,病变检出率86 .8% (33/38) ;其中空回肠克罗恩病7例,空回肠多发溃疡5例,空肠血管畸形并出血4例,空肠多发憩室4例,空回肠静脉显露3例,小肠恶性间质瘤2例,非特异性回肠炎2例,回肠中分化腺癌1例,回肠钩虫病1例,嗜酸细胞性小肠炎1例,吻合口狭窄1例,回肠结核1例,空肠蛔虫病1例,未发现病灶5例。检查过程中无明显并发症发生,2例因腹痛不能耐受中途放弃检查,其余患者均可完成检查。结论:双球囊推进式小肠镜可直视检查全小肠腔病变,病变检出率高,是一种安全、可靠、临床诊断和治疗小肠疾病的有利工具,适当护理配合是获得满意操作结果的重要条件。

Coordination Care in the Double-balloon Push-type Enteroscopy

Objective To evaluate the oper ational pe rformance, safety and feature of nursing care of double-balloon push-type entero scopy in patients with unexplained small bowel diseases.Methods Be tween July 2003 and March 2004, 38 patients with gastrointestinal disorders and negative of some examinations (upper endoscopy and colonscopy, motor meal, abdom inal angiography, etc) under enteroscopy. Enteroscopy with the double-balloon te chnique was carried out using the oral approach depend can't not reach the ileoc ecal junction.Results Lesions were detected in 33 patients (86.8 %). In jejunoileum 7 patients with Crohn's disease;5 with multiple ulcer; 3 wit h varicosities. In jejunum 4 with angiodysplasias and bleeding;4 with multiple diverticulum.In ileum 2 with non-specificity inflammation;1 with moderately dif ferentiated adenocarcinomal;1 with ancylostomiasis;1 with tuberculosis. 1 patie nt with malignancy interstitialoma; 1 with stenosis of stoma;1 with acidophilic enteritis. During the investigation no obviously complication was occurred, 2 pa tients quit the enteroscopy for the unbearable abdominal pain.Conclusion s Double-balloon push-type enteroscopy can visualized the whole small bowe l, and find the lesions easily. With the good nuring care, double-balloon push-t ype enteroscopy is a safe and reliable tecnique in the clinical diagnosis and tr eatment of the small bowel diseases.