双气囊电子小肠镜临床应用初探

目的探讨小肠疾病检查新方法——双气囊电子小肠镜的操作、诊断效果、适应证等问题。方法应用双气囊电子小肠镜对13例疑诊小肠疾病的患者进行双气囊小肠镜检查。分别从口侧或肛侧进镜，利用外套管、内镜前端的双气囊交替充气、放气和交替滑进，推进小肠镜进入小肠检查。记录检查范围、时间、耐受性及病变等。结果13例患者共行小肠镜检查19例次(11例次接受了口侧进镜，8例次接受了肛侧进镜)，每侧进镜术程平均80min。从口侧进镜均达第3～6组小肠，从肛侧进镜达4～6组小肠。发现空肠良性问质瘤1例、空肠淋巴瘤1例、回肠溃疡狭窄及憩室2例、空肠息肉2例、空肠糜烂2例。口侧进镜患者，术中多数出现恶心、消化液自口及外滑管口溢出，偶尔出现一过性轻微腹痛；肛侧进镜患者无明显不适及反应；未出现出血、穿孔等并发症。结论双气囊小肠镜是一种新型小肠疾病检查手段，平均2～3h可检查完所有小肠，进镜迅速。于操作直视下观察病变，通过活检对病变进行定性检查。病变检出率明显优于小肠钡剂造影，具有安全、可控性、直视、图像清晰等优点，适用于无肠粘连及严重脏器功能不全的小肠疾病患者。

Application of double-balloon enteroscopy in clinics

Objective To study a new endoscopic technique, double-balloon enteroscopy on its efficiency and indication of examining small intestinal diseases. Methods Thirteen patients suspected to suffer from small intestinal disease received double-balloon enteroscopy. By pumping the two balloons to grip the small intestinal walls, the enteroscope can be inserted further without forming redundant loops in the small intestine. Eight patients undergoing these procedures received a combination of sedative drugs and anisodam-ine intravenously. Results Nineteen procedures were performed in 13 patients, among them 8 patients were performed through anus and 11 patients through mouth. The enteroscope reached the 3th - 6th group small intestine through mouth or anus in average 80 minutes for each procedure. Eight positive lesions were detected or diagnosed by the enteroscopy and biopsy. The nausea, mild temporary abdominal pain and liquids effusing from the overtube occurred during examination through the mouth. There were no severe complications such as hemorrhage, perforation occurred. Conclusion The double-balloon enteroscopy is a new safe and controllable endoscopic procedure for those small intestinal disease patients without severe organ dysfunction and intestinal adhesion, and having the adventages of completing the procedure within 2-3 hours, allowing direct visualization of the entire small intestine, taking biopsy specimens to get pathological diagnosis, and is superior to barium enteroclysis.