根据临床表现，单气囊小肠镜在小肠疾病的诊断和治疗中的应用：回顾性研究。
The utility of single-balloon enteroscopy for the diagnosis and management of small bowel disorders according to their clinical manifestations: a retrospective review.
出版信息
BMC Gastroenterol. 2013 Jun 22;13:103. doi: 10.1186/1471-230X-13-103.
BACKGROUND
The advent of double-balloon enteroscopy has enabled more accurate diagnosis and treatment of small bowel disorders. Single-balloon enteroscopy permits visualization of the entire small intestine less often than does double-balloon enteroscopy. However, the relative clinical advantages of the 2 methods remain controversial. This study therefore aimed to identify the indications for and therapeutic impact of performing single-balloon enteroscopy.
METHODS
We retrospectively reviewed prospectively collected data from adults who underwent single-balloon enteroscopy from January 2007 through November 2011 and analyzed their baseline characteristics, endoscopic findings, pathological diagnoses, and clinical outcomes.
RESULTS
A total of 145 procedures were performed in 116 patients with a mean age of 58.1 ± 17.7 years (range, 18-89 years). The most common indications for performing single-balloon enteroscopy were overt gastrointestinal (GI) bleeding, chronic diarrhea, and occult GI bleeding, accounting for 57.9%, 12.4%, and 9.7% of the patients, respectively. The area of interest was achieved in 80.7% of the cases, with a 5.5% rate of technical failure. An overall positive finding was detected in 65.5% of the cases, of which 33.8% were ulcers and erosions; 8.3%, masses; and 3.4%, angiodysplasia. The diagnostic yields were 42.9%, 52.4%, 78.6%, 50.0%, and 25.0% for patients with overt GI bleeding, occult GI bleeding, abdominal pain, chronic diarrhea, and abnormal imaging results, respectively. Therapeutic procedures were performed in 11% of patients with GI bleeding and achieved a therapeutic yield of 14.6% with a minor complication rate of 11.7%.
CONCLUSIONS
Single-balloon enteroscopy was effective for the diagnosis and treatment of small bowel disorders, especially in patients who presented with abdominal pain, GI bleeding, or focal abnormalities on imaging scans.
背景
双气囊小肠镜的出现使小肠疾病的诊断和治疗更加准确。与双气囊小肠镜相比，单气囊小肠镜检查通常无法观察整个小肠。然而，这两种方法的相对临床优势仍存在争议。因此，本研究旨在确定单气囊小肠镜的适应证和治疗效果。
方法
我们回顾性分析了 2007 年 1 月至 2011 年 11 月期间行单气囊小肠镜检查的成年患者的前瞻性数据，分析了他们的基线特征、内镜表现、病理诊断和临床结果。
结果
116 例患者共进行了 145 例次单气囊小肠镜检查，平均年龄为 58.1±17.7 岁（18-89 岁）。行单气囊小肠镜检查的最常见适应证为显性胃肠道（GI）出血、慢性腹泻和隐性 GI 出血，分别占患者的 57.9%、12.4%和 9.7%。80.7%的病例达到了目标部位，技术失败率为 5.5%。总体阳性发现率为 65.5%，其中 33.8%为溃疡和糜烂；8.3%为肿块；3.4%为血管发育不良。显性 GI 出血、隐性 GI 出血、腹痛、慢性腹泻和异常影像学结果患者的诊断率分别为 42.9%、52.4%、78.6%、50.0%和 25.0%。对 GI 出血患者进行了治疗性操作，治疗率为 11%，并发症发生率为 11.7%。
结论
单气囊小肠镜对小肠疾病的诊断和治疗有效，特别是对有腹痛、GI 出血或影像学扫描有局灶性异常的患者。
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