双气囊小肠镜诊断小肠疾病的临床应用研究

目的通过对原因不明怀疑为小肠疾病的患者进行双气囊小肠镜检查,分析其检出率、观察范围、不良反应、并发症及患者的耐受性,探讨其临床应用价值。方法40例经B超、CT、胃镜、肠镜等常规检查不能明确病因的患者,其中消化道出血22例,反复腹痛12例,腹泻待查4例,腹胀待查2例,接受双气囊小肠镜检查,评价其阳性率、确诊率、并发症发生率等。结果40例患者共进行45次检查,18例经口进镜,17例经肛,5例接受经口 经肛检查。40例患者中34例发现阳性病灶,总体阳性率85%;不明原因消化道出血病因确诊率77%(17/22),腹痛、腹泻的阳性诊断率分别为67%(8/12)和50%(2/4),2例腹胀患者1例获得诊断(50%)。未见操作相关的严重不良反应和并发症。结论双气囊小肠镜检查安全、可靠,阳性率显著提高,为小肠疾病诊断提供了有效的检查手段。

Comparative studies of double balloon enteroscopy and barium enteroclysis in etiological diagnosis of small bowel diseases

Objective To analyze its positive rate, observation yield, side effect, complication, and tolerance of patients, and to further evaluate its clinical diagnostic efficacy via chenking patients suspected with small bowel diseases with double balloon enteroscopy. Methods Among 40 cases with negative findings of other routine diagnostic modalities as B supersonic, CT, gastric endoscopy, and colonic enscopy, 22 cases were with obscure GI bleeding, 12 cases with abdominal pain, 4 cases with diarrhea, and 2 cases with abdominal distention, double balloon enteroscopy was performed and the findings were analysed. Results 45 endoscopies were performed, 18 via mouth route, 17 via anus route, both mouth route and anus route in 5 cases. Lesions were detected in 34 of 40 patients, positive rate is 85%. In 22 cases with obscure GI bleeding, 17 cases obtained final diagnosis, the rate was 77%. It was 67%, 50%, and 50%, respectively in 12 cases with abdominal pain, 4 cases with diarrhea, and 2 cases with abdominal distention. No severe side effect and complication were observed. Conclusions Double balloon enteroscopy was safe, reliable, and its positive rate was elevated. It provided an effective method for diagnosis of small bowel diseases.