双气囊电子小肠镜在小肠疾病诊断中的应用价值

目的:探讨和评价双气囊电子小肠镜(DBE)对小肠疾病的诊断价值、安全性及适应症.方法:对怀疑或证实有小肠疾病的183例患者在异丙酚麻醉/镇静状态下进行210例次(经口检查61例,经肛门检查95例,双侧对接检查27例)DBE检查.结果:检查成功率为99.5%(209/210),平均检查时间75(30-180)min.小肠病变阳性检出率为71.0%(130/183),检出的主要病变有:小肠炎症性改变(n=43)、小肠Crohn病(n=19)、小肠血管发育不良(n=17)、小肠息肉(n=14)、小肠肿瘤(n=14,恶性10例,良性4例)、Peutz-Jeghers综合征(n=8)、小肠憩室及小肠寄生虫病各4例,其他少见小肠疾病7例.仅少数患者检查结束后有轻微咽部或肛门部疼痛不适和腹胀.结论:DBE能够对整个小肠进行直视检查,检查成功率高,安全可靠,对小肠疾病检出率高,可作为小肠疾病诊断的首选方法.

Double balloon endoscopy for the diagnosis of small intestinal disorders

AIM:To evaluate the diagnostic rates,in-dications and complications of double balloon enteroscopy(DBE)for small-bowel diseases METHODS:A total of 183 patients with suspect-ed or known small-bowel disease underwent 210 DBE procedures(under anesthesia with pro-pofol,via an oral approach 61 patients,an anal approach in 95 patients,or both approaches 27 patients)at our institution.RESULTS:The success rate of DBE was 99.5%(209/210).The mean duration of the procedure was 75(30-180)min.A positive diagnosis was achieved in 130 patients,giving an overall of 71.0%(130/183).The main discovered small-bowel diseases were as follows:jejunitis/ileitis(n = 43),Crohn's disease(n = 19),angiodysplastic lesions(n = 17),polyps(n = 14),tumor(n = 14,malignancy 10,benign 4),Peutz-Jeghers syn-drome(n = 8),diverticula and celiosites of the small intestine(n = 4 respectively),and otherrare diseases of the intestine(n = 7).A few pa-tients complained of light indisposition or pain in the pharyngeal portion or pars analis after the DBE procedure.CONCLUSION:The procedure is safe and use-ful,provides high diagnostic yields,and can be regarded as the first-choice of examination pro-cedure for suspected small-bowel diseases.