【摘要】 背景:不明原因消化道出血(OGIB)的诊治是临床一大难题,气囊辅助小肠镜(BAE)对OGIB的诊断具有独到优势。目的:探讨BAE对OGIB的诊断和治疗价值。方法:收集2009年1月—2015年3月中国人民解放军空军总医院诊断为OGIB并接受BAE检查的患者124例,回顾性分析入选者的BAE诊断结果、治疗、随访、并发症等。对双气囊小肠镜(DBE)、单气囊小肠镜(SBE)经口、经肛检查进行比较。对BAE与胶囊内镜(CE)、消化道钡剂造影、血管造影的诊断效率进行比较。结果:DBE与SBE经口、经肛检查的进镜深度、进镜时间以及阳性检出率差异均无统计学意义(P>0.05)。BAE、CE、消化道钡剂造影、血管造影的阳性检出率分别为68.5%(85/124)、51.1%(24/47)、38.1%(8/21)以及21.4%(3/14),BAE的阳性检出率显著高于CE、消化道钡剂造影以及血管造影(P<0.05)。BAE、CE、消化道钡剂造影以及血管造影的特异性分别为97.5%、62.5%、54.5%以及66.7%,敏感性分别为100%、65.2%、30.0%以及12.5%,BAE的特异性和敏感性均显著高于CE、消化道钡剂造影以及血管造影(P<0.05)。23例患者行BAE镜下治疗,治疗后出血均停止。124例患者均完成BAE检查,无并发症发生。结论:BAE是一项安全、有效的诊断和治疗OGIB的方法。更多还原

【Abstract】 Background: Diagnosis and treatment of obscure gastrointestinal bleeding( OGIB) is a difficult problem in clinics,and balloon-assisted enteroscopy( BAE) has unique advantage in diagnosis of OGIB. Aims: To investigate the diagnostic and therapeutic value of BAE in OGIB. Methods: A total of 124 OGIB patients undergone BAE from Jan. 2009 to Mar.2015 at Air Force General Hospital of Chinese PLA were enrolled,and the diagnostic result,treatment,follow-up and complications were retrospectively analyzed. Double-balloon enteroscopy( DBE) and single-balloon enteroscopy( SBE) by oral and anal route were compared. Also,diagnostic efficiency of BAE,capsule endoscopy( CE),gastrointestinal barium examination and angiography were compared. Results: No significant difference was found between DBE and SBE in insertion depth,procedure time and positive detection rate by oral and anal route( P > 0. 05). Positive detection rates of BAE,CE,gastrointestinal barium examination and angiography were 68. 5%( 85 /124),51. 1%( 24 /47),38. 1%( 8 /21) and 21. 4%( 3 /14),respectively; the detection rate of BAE was significantly higher than the others( P < 0. 05).Specificity of BAE,CE,gastrointestinal barium examination and angiography were 97. 5%,62. 5%,54. 5% and 66. 7%,respectively; and sensitivity were 100%,65. 2%,30. 0% and 12. 5%,respectively. Specificity and sensitivity of BAE were significantly higher than the others( P < 0. 05). Endoscopic therapy performed by BAE in 23 patients were all successful. All of the 124 patients completed the BAE examination and no complication occurred. Conclusions: BAE is a safe and effective diagnostic and therapeutic tool for OGIB.更多还原