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双气囊推进式电子小肠镜对小肠疾病的诊断应用

Application of double-balloon push enteroscopy in the diagnosis of small bowel disorders

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【作者】 沙卫红李瑜元聂玉强黎庆宁周永健王红梁培智佘庆珠吴惠生

【Author】 SHA Wei-hong, LI Yu-yuan, NIE Yu-qiang, et al. Department of Gastroenterology, First Municipal Hospital of Guangzhou, Guangzhou 510180, China

【机构】 广州市第一人民医院消化内科广州市第一人民医院消化内科 510180510180

【摘要】 目的 评价双气囊推进式小肠镜对小肠疾病的诊断价值。方法 对2003年7月至2004年3月间38例有消化道症状,但是经胃镜、结肠镜、全消化道钡餐、腹部血管造影等检查为阴性者,进行双气囊推进式电子小肠镜检查。根据患者病情决定从上消化道或下消化道插镜,其中8例经上消化道插镜未能到达回盲部者改从下消化道插镜。结果 双气囊推进式小肠镜检查发现有小肠病变33例(检出率86.8%),其中空回肠克罗恩病7例,空回肠多发溃疡5例,空肠血管畸形并出血4例,空肠多发憩室4例,空回肠静脉显露3例,小肠恶性间质瘤2例,非特异性回肠炎2例,回肠中分化腺癌1例,空肠钩虫病1例,回肠蛔虫病1例,嗜酸细胞性小肠炎1例,吻合口狭窄1例,回肠结核1例。检查过程中未见明显并发症,除2例因腹痛不能耐受而中途放弃外,其余患者均可完成检查。结论 双气囊推进式小肠镜可直视检查全小肠腔内病变,病变检出率高,安全性好,是诊断和治疗小肠疾病的有利工具,但操作难度较高。

【Abstract】 Objective To evaluate the diagnostic efficacy of double-balloon push enteroscopy in small bowel disorders. Methods From July 2003 to March 2004, 38 patients with presentation of gastrointestinal upset and underwent a previous negative gastroscopy, colonoscopy, gastrointestinal barium and/or angiography were enrolled in this study. Enteroscopy via oral or rectum was done in 30 patients while in the other 8 patients full access to the small bowel was attempted by the two-way method, firstly via upper GI and then the lower GI. Results Positive diagnostic yield was made in 33 patients (86. 8% ). These disorders included Crohn’s disease (7/38) , multiple ulcerations (5/38) , arteriovenous malformation (4/38) , multiple diverticula (4/38) , varices (3/38) , malignant stromal tumor (2/38) , ileitis (2/38) , and 1 case in each of moderate-differentiated adenocarcinoma, Ankylostoma duodenale, ascariasis, eosinophilic enteritis, anas-tomotic stricture and tuberculosis. The procedures were carried out satisfactorily in all patients but 2 failed from the intolerance of patients. Complication never occurred. Conclusion Double-balloon push enteroscopy has the superiority in direct visualization of whole small intestine with high positive findings and safety but with high technical demand in manipulation.

【关键词】 小肠镜小肠疾病诊断
【Key words】 EnteroscopySmall bowel diseaseDiagnosis
  • 【文献出处】 中华消化内镜杂志 ,Chinese Journal of Digestive Endoscopy , 编辑部邮箱 ,2004年03期
  • 【分类号】R574.5
  • 【被引频次】27
  • 【下载频次】136
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