Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China (mainland).
Med Sci Monit. 2020 Feb 26;26:e920555. doi: 10.12659/MSM.920555.
BACKGROUND Double balloon enteroscopy (DBE) is a diagnosis and therapy method for suspected small bowel bleeding (SSBB). The data for emergent DBE is limited in overt SSBB cases. The aim of this study was to investigate the role of diagnosis and therapy of emergent DBE in patients with overt SSBB. MATERIAL AND METHODS The clinical and endoscopic data for patients with overt SSBB undergoing DBE in a single center from January 2010 to December 2017 were collected and analyzed. Emergent DBE was defined as DBE performed less than 3 days of last bleeding onset. RESULTS A total of 265 DBEs in 265 patients with overt SSBB were enrolled (mean age, 44.7±17.3 years; 66.8% males). The patients were divided into 3 groups according to the timing of DBE: less than 3 days (n=32), more than 3 days and less than 7 days (n=146), and more than 7 days (n=87) (first group was the emergent group, the latter 2 groups were the non-emergent groups). The diagnosis yield for the emergent group was significantly higher than the non-emergent groups (84.4% versus 65.1% or 59.8%, respectively, P<0.05), but was not different between the 2 non-emergent groups (P>0.05). The top 3 diagnoses were angioectasias (19.6%), diverticulum (16.2%), and tumor (12.1%). For therapy yield, there was a remarkable reducing trend in the emergent group (<3 days), and the 2 non-emergent groups (3 to 7 days group and >7 days group: 78.1%, 58.2% and 39.1%, respectively, P<0.05. The top 3 endoscopic treatments were hemostatic clips (21.9%), argon plasma coagulation (15.8%), and epinephrine injection (14.0%). CONCLUSIONS The emergent DBE had the highest yields for diagnosis and therapy. The study finding showed a pivotal role of emergent DBE in overt SSBB.
双气囊内镜（DBE）是一种用于疑似小肠出血（SSBB）的诊断和治疗方法。在显性 SSBB 病例中，紧急 DBE 的数据有限。本研究的目的是探讨在显性 SSBB 患者中，紧急 DBE 的诊断和治疗作用。
收集并分析了 2010 年 1 月至 2017 年 12 月在一家单中心接受显性 SSBB 治疗的患者进行 DBE 的临床和内镜数据。紧急 DBE 定义为距最后一次出血发作不到 3 天的 DBE。
共纳入 265 例显性 SSBB 患者的 265 例 DBE（平均年龄 44.7±17.3 岁；男性占 66.8%）。根据 DBE 的时间将患者分为 3 组：<3 天（n=32）、>3 天和<7 天（n=146）以及>7 天（n=87）（第一组为紧急组，后两组为非紧急组）。紧急组的诊断检出率明显高于非紧急组（84.4%与 65.1%或 59.8%，分别，P<0.05），但两组非紧急组之间无差异（P>0.05）。前 3 种诊断分别为血管扩张（19.6%）、憩室（16.2%）和肿瘤（12.1%）。对于治疗检出率，紧急组（<3 天）以及 2 个非紧急组（3 至 7 天组和>7 天组）呈显著下降趋势：78.1%、58.2%和 39.1%，分别，P<0.05。前 3 种内镜治疗分别为止血夹（21.9%）、氩等离子凝固术（15.8%）和肾上腺素注射（14.0%）。
紧急 DBE 的诊断和治疗检出率最高。研究结果表明，在显性 SSBB 中，紧急 DBE 具有关键作用。
