【摘要】 目的比较双气囊小肠镜和胶囊内镜对原因不明的慢性腹痛患者的病变检出情况,评价双气囊小肠镜对原因不明的慢性腹痛的诊断价值,探讨小肠疾病导致慢性腹痛的常见病因。方法将46例经胃镜、结肠镜、钡餐等检查结果阴性的慢性腹痛患者行双气囊小肠镜检查,首选进镜方式为经口和经肛2种,首选方式检查后未发现病灶者,改换进镜方式再行检查。另70例患者行胶囊内镜检查。两组患者的相关检查分别由专门医师独立操作并诊断,最后进行汇总分析。结果双气囊小肠镜组46例患者中,15例经口进镜,22例经肛门进镜,9例行口-肛门进镜。通过双气囊小肠镜检查发现病灶28例,小肠病变检出率60.87%;胶囊内镜组70例患者中,29例发现小肠病变,小肠病变检出率为41.43%;双气囊小肠镜的病变检出率明显高于胶囊内镜,差异有统计学意义(P<0.05)。双气囊小肠镜组和胶囊内镜组检出病变中,以克罗恩病最为常见(分别为9例和8例),其次为非特异性肠炎。结合小肠镜检查结果、手术及临床上药物治疗效果,双气囊小肠镜组诊断疾病的准确率为82.14%(23/28)。其中除1例患者发生急性胰腺炎外,其余患者均未见严重的不良反应及出血、穿孔等严重的并发症。结论双气囊小肠镜对小肠病变所致的慢性腹痛阳性病变检出率高于胶囊内镜,诊断准确率较高,是一种安全可靠的检查手段;导致慢性腹痛的小肠疾病最常见病因为克罗恩病,其次为非特异性肠炎。更多还原

【Abstract】 Objective To compare the relevance ratios of double balloon enteroscopy and capsule endoscopy in patients with unexplained chronic abdominal pain,evaluate the diagnostic value of double balloon enteroscopy and analyze the etiology of chronic abdominal pain resulted from enteral diseases.Methods Forty-six cases with chronic abdominal pain who previously underwent negative gastroscopy,colonoscopy or gastrointestinal barium received double balloon enteroscopy.The route could be either via mouth or anus.Negative results of initial route were required for another route.Seventy cases with obscure chronic abdominal pain received capsule endoscopy.Two groups were operated and diagnosed independently by a specialist.Results In double-ballon enteroscopy group,there were fifteen patients via oral,twenty-two cases via anus,and nine cases via both anus and oral.There were twenty-eight patients with positive results,the detection rate was 60.87%;in capsule endoscopy group,twenty-nine patients were found with intestinal lesions,the detection rate was 41.43%.The detection rate of double-balloon enteroscopy was higher than that of capsule endoscopy,the difference was statistically significant.The most common reason for abdominal pain was crohn’s disease(nine in double-balloon enteroscopy and eight in capsule endoscopy).Combined with surgery and clinical effects of drugs treatment,the diagnostic accuracy of double balloon enteroscopy was 82.14%(23/28).Except for an acute pancreatitis,no procedure-related severe adverse events or severe complications such as hemorrhage or perforation occurred in all cases.Conclusions Doubel-balloon enteroscopy is superior to capsule endoscopy in diagnosing obscure chronic abdominal pain from small bowel diseases.It is a safe and reliable method with high diagnostic accuracy.The most common causes of obscure abdominal pain were Crohn’s disease and non-specific colitis.更多还原