CT小肠成像与双气囊小肠镜在疑似小肠出血诊断中的临床应用

目的 通过对疑似小肠出血患者的临床资料进行回顾性分析,探讨CT小肠成像(CTE)与双气囊小肠镜(DBE)在疑似小肠出血诊断中的应用价值.方法 回顾性分析2019年10月-2020年10月于安徽医科大学第一附属医院消化内科住院的54例疑似小肠出血患者的临床资料,统计CTE及DBE对疑似小肠出血诊断的阳性结果及并发症发生例...

Clinical application of CT enterography and double-balloon enteroscopy in the diagnosis of suspected small intestinal bleeding

  Objective  The clinical data of patients with suspected small bowel bleeding in our hospital were analyzed retrospectively to explore the application value of CT enterography (CTE) and double-balloon enteroscopy (DBE) in the diagnosis of suspected small bowel bleeding.  Methods  The clinical data of 54 patients with suspected small bowel bleeding hospitalized in the Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University from October 2019 to October 2020 were analyzed retrospectively. The positive results of CTE and DBE in the diagnosis of suspected small bowel bleeding and the cases of complications were counted. The results were counted by the 2 test or exact probability method of Fisher test. The diagnostic rate and complication rate of intestinal hemorrhage were compared by CTE and DBE, and the diagnostic value and safety of CTE and DBE were discussed.  Results  All the 54 patients completed CTE and DBE examination, with a success rate of 100%. The lesions mainly included diverticulum, ulcer, vasodilation, tumor and Crohn's disease. The diagnosis rate of lesions by CTE was 53.7% (29/54) compared with 79.6% (43/54) by DBE and the difference was significant (χ2=8.167, P < 0.01). In terms of safety comparison, there was no complications in all patients who underwent CTE examination (0/54). However, the incidence of complications in 54 patients examined by DBE was only 1 case, and the incidence of complications was 1.9% (1/54). No significant difference was observed in the incidence of complications between CTE and DBE (P>0.05).  Conclusion  The diagnostic rate of DBE in small bowel bleeding is significantly higher than that of CTE, and without serious complications. The diagnostic rate of CTE for ulcer and vasodilation is not high, but it is sensitive to diverticulum, tumor and Crohn's disease. CTE combined with DBE examination can effectively avoid missed diagnosis of small bowel bleeding.