单气囊小肠镜对老年患者小肠疾病诊断的应用

目的评价单气囊小肠镜(single balloon enteroscopy,SBE)对老年患者小肠疾病的诊断价值。方法回顾性分析首都医科大学附属北京友谊医院消化分中心2017年1月至2019年12月行全身静脉麻醉SBE检查老年患者60例,与同期检查的146例非老年患者进行比较。结果60例老年患者均能耐受检查,检出阳性率为46.7%(28/60),老年患者SBE检查时间为22~172 min,平均检查时间为76.9 min。老年患者主要受检原因为不明原因消化道出血56.7%(34/60),老年患者因腹痛受检比例16.7%(10/60)显著低于非老年组患者34.2%(50/146)(P=0.018)。老年患者检出主要疾病为小肠肿瘤28.6%(8/28)及血管病变28.6%(8/28),在检出疾病中老年患者小肠炎症、溃疡的发生比例25.0%(7/28)显著低于非老年患者48.4%(30/62)(P=0.037)。老年患者的小肠病变检出率、操作时间、并发症发生率与同期检查的非老年患者相同,差异无统计学意义(P>0.05)。结论SBE对老年患者小肠疾病的诊断是一种安全、可靠的手段。

Application of single balloon enteroscopy in diagnosis of small intestinal diseases in elderly patient

Objective To evaluate the clinical value of single balloon enteroscopy(SBE)in the diagnosis of small intestinal diseases in elderly patient.Methods A total of 60 elderly patients who underwent SBE under general intravenous anesthesia from Jan.2017 to Dec.2019 in Beijing Friendship Hospital were retrospectively analyzed,and compared with 146 cases of non-elderly patients examined at the same time.Results 60 elderly patients were able to tolerate checks.The positive rate was 46.7%(28/60).The examination time of SBE was from 22 minutes to 172 minutes(mean 76.9 minutes).The main reason of SBE in elderly patients were obscure gastrointestinal bleeding 56.7%(34/60),and the proportion of elderly patients with abdominal pain was 16.7%(10/60),which was significantly lower than that of non-elderly patients 34.2%(50/146)(P=0.018).The main diseases were small intestinal tumor 28.6%(8/28)and vascular disease 28.6%(8/28).The incidence rate of intestinal inflammation and ulcer in elderly patients 25.00%(7/28)was significantly lower than that in non-elderly patients 48.4%(30/62)(P=0.037).There was no significant difference in the detection rate,operation time and complication rate between the two groups(P>0.05).Conclusion SBE is a safe and reliable method for diagnosis of samll intestinal diseases in elderly patient.