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单气囊小肠镜检查的诊断率及治疗效果:106例病例系列研究

Diagnostic yield and therapeutic impact of single-balloon enteroscopy: series of 106 cases.

作者信息

Ramchandani Mohan, Reddy D Nageshwar, Gupta Rajesh, Lakhtakia Sandeep, Tandan Manu, Rao Guduru V, Darisetty Santosh

机构信息

Asian Institute of Gastroenterology, Hyderabad, India.

出版信息

J Gastroenterol Hepatol. 2009 Oct;24(10):1631-8. doi: 10.1111/j.1440-1746.2009.05936.x. Epub 2009 Aug 3.

Abstract

BACKGROUND AND AIM

Single-balloon enteroscopy (SBE) is a novel method of balloon assisted enteroscopy which allows deep intubation of intestine and has therapeutic potential. This prospective study was done in a tertiary care center to evaluate the feasibility, complications, diagnostic and therapeutic yield of SBE in patients with suspected small bowel disorders.

METHODS

One hundred and six patients (mean age 40.1 years, range 12-76 years, 65 men) with suspected small bowel diseases underwent 131 SBE procedures between February 2007 and July 2008.

RESULTS

Indications for SBE included obscure gastrointestinal bleeding (OGIB) (40), chronic abdominal pain with abnormal imaging studies (34), chronic diarrhea (20), polyposis syndromes (11) and foreign body (1).The mean insertion depth was 255.8 +/- 84.5 cm beyond the duodenojejunal flexure by the oral route and 163 +/- 59.3 cm proximal to the ileocecal valve by the per anal approach. The mean duration of the procedure for antegrade and retrograde enteroscopy was 65.9 +/- 19.5 min and 72.3 +/- 18.3 min, respectively. Pan-enteroscopy was possible in 25% of cases (five of 20 cases in which total enteroscopy was attempted). Diagnostic yields in cases of OGIB, chronic abdominal pain and chronic diarrhea were 60%, 65% and 55%, respectively. Overall new diagnosis was established in 46% and the extent of known disease was assessed in 15% of cases. In 21% of patients, therapeutic interventions were carried out while surgical treatment was directed to 8.4% of the patients. No major complications were observed.

CONCLUSION

SBE is well tolerated and has good diagnostic yield, having a similar yield to previous double-balloon enteroscopy reports.

摘要

背景与目的

单气囊小肠镜检查(SBE)是一种新型的气囊辅助小肠镜检查方法,可实现小肠深度插管,具有治疗潜力。本前瞻性研究在一家三级医疗中心进行,旨在评估SBE在疑似小肠疾病患者中的可行性、并发症、诊断及治疗效果。

方法

2007年2月至2008年7月期间,106例疑似小肠疾病患者(平均年龄40.1岁,范围12 - 76岁,男性65例)接受了131次SBE检查。

结果

SBE的适应证包括不明原因的消化道出血(OGIB)(40例)、影像学检查异常的慢性腹痛(34例)、慢性腹泻(20例)、息肉综合征(11例)及异物(1例)。经口途径平均插入深度为十二指肠空肠曲以远255.8±84.5 cm,经肛门途径为回盲瓣近端163±59.3 cm。顺行和逆行小肠镜检查的平均操作时间分别为65.9±19.5分钟和72.3±18.3分钟。25%的病例可行全小肠镜检查(20例尝试全小肠镜检查的病例中有5例)。OGIB、慢性腹痛和慢性腹泻病例的诊断率分别为60%、65%和55%。总体而言,46%的病例确立了新诊断,15%的病例评估了已知疾病的范围。21%的患者进行了治疗干预,8.4%的患者接受了手术治疗。未观察到严重并发症。

结论

SBE耐受性良好,诊断率高,与以往双气囊小肠镜检查报告的诊断率相似。

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