双气囊小肠镜检查用于不明原因胃肠道出血时所遇到的非小肠病变。
Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding.
机构信息
A W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown Rd, Sydney 2050, Australia.
出版信息
World J Gastroenterol. 2010 Apr 21;16(15):1885-9. doi: 10.3748/wjg.v16.i15.1885.
AIM
To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their significance.
METHODS
A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during DBE.
RESULTS
There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 +/- 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular lesions.
CONCLUSION
A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required.
目的
报告在双气囊小肠镜（DBE）检查中遇到的非小肠出血性病变的发生率，并分析其意义。
方法
对 2004 年 6 月至 2008 年 11 月在三级转诊中心进行的前瞻性 DBE 数据库进行回顾性研究。分析了 179 例因不明原因胃肠道出血（OGIB）而接受 DBE 的患者，以寻找 DBE 过程中遇到的非小肠病变（NSBL；所有和新诊断）的发生率。
结果
179 例患者共进行了 228 次（150 次顺行和 78 次逆行）DBE 检查。每位患者的平均 DBE 检查次数为 1.27 次。患者的平均年龄（标准差）为 62+/-16 岁。女性 94 例（52.5%）。出血性病变的阳性检出率为 65.9%。179 例患者中，44 例（24.6%）有 NSBL（其中 19 例同时存在小肠病变和 NSBL）；27 例（15.1%）有以前内镜检查未发现的病变。最常见的漏诊病变类型为血管病变。
结论
相当一部分患者（24.6%）有常规内镜能够到达的病变。可能需要仔细重复胃镜和结肠镜检查。
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