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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 被引量:23

Application of double-balloon push enteroscopy in the diagnosis of small bowel disorders
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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。 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.
出处 《中华消化内镜杂志》 2004年第3期177-180,共4页 Chinese Journal of Digestive Endoscopy
关键词 双气囊推进式电子小肠镜 小肠疾病 诊断 肠镜检查 不完全性小肠梗阻 Enteroscopy Small bowel disease Diagnosis
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