单中心双气囊小肠镜在小肠疾病诊断和治疗中的经验分析：466 例回顾性研究。

Single-centre empirical analysis of double-balloon enteroscopy in the diagnosis and treatment of small bowel diseases: A retrospective study of 466 cases.

机构信息

Department of Digestive System, Kunhua Hospital Affiliated to Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, No. 157 Jinbi Road, Kunming, 650032, Yunnan, China.

Medical School, Kunming University of Science and Technology, No. 727 Jingming South Road, Kunming, 650500, Yunnan, China.

出版信息

Surg Endosc. 2022 Oct;36(10):7503-7510. doi: 10.1007/s00464-022-09179-w. Epub 2022 Mar 14.

DOI:10.1007/s00464-022-09179-w

PMID:35286470

Abstract

BACKGROUND AND OBJECTIVE

The diagnosis and treatment of small bowel diseases (SBDs) has always been a challenge. The purpose of this study was to evaluate the value of double-balloon enteroscopy (DBE) in the diagnosis and treatment of small bowel diseases.

METHOD

The clinical data of 466 patients who underwent double-balloon enteroscopy (DBE) in the Endoscope Center of Gastroenterology Department of the First People's Hospital of Yunnan Province from Jan. 2015 to Dec. 2020 were analysed retrospectively. The factors included age, sex, indications, endoscopic treatment results, pathological results, discharge diagnosis and so on.

RESULTS

A total of 370 patients underwent 466 double-balloon enteroscopies, among whom 274 underwent one examination and 96 received two-way examinations (oral and transanal approaches). Abnormalities were detected in 299 cases, with a detection rate of 80.81% (299/370). The common indications were occult gastrointestinal bleeding (OGIB) (30.8%, 114/370) and abdominal pain (28.3%, 105/370). The diagnosis rates were 64.9% and 77.1%, respectively. The common positive findings included nonspecific inflammation/erosion (60 cases), ulcers (34 cases), diverticulum (32 cases), polyps (26 cases) and Crohn's disease (CD) (24 cases). The common tumours were lymphoma(12 cases), adenocarcinoma(11 cases) and stromal tumour(8 cases). Lymphoma was mostly located in the ileum, while stromal tumours and adenocarcinoma were mostly located in the duodenum and jejunum. The main endoscopic intervention measures were haemostasis and polypectomy, including haemostatic clip, argon plasma coagulation (APC), endoscopic mucosal resection (EMR), endoscopic trap resection, endoscopic foreign body extraction and other operations, without serious complications.

CONCLUSION

DBE has a high success rate in the diagnosis and treatment of some SBDs, and it is a safe and effective management method.

摘要

背景与目的

小肠疾病（SBD）的诊断和治疗一直是一个挑战。本研究旨在评估双气囊小肠镜（DBE）在小肠疾病诊断和治疗中的价值。

方法

回顾性分析 2015 年 1 月至 2020 年 12 月云南省第一人民医院消化内科内镜中心 466 例行双气囊小肠镜检查（DBE）患者的临床资料，包括年龄、性别、适应证、内镜治疗结果、病理结果、出院诊断等。

结果

共 370 例患者行 466 次双气囊小肠镜检查，其中 274 例患者行单次检查，96 例患者行双向检查（经口和经肛入路）。299 例（80.81%，299/370）发现异常。常见的适应证为隐匿性胃肠道出血（OGIB，30.8%，114/370）和腹痛（28.3%，105/370）。诊断率分别为 64.9%和 77.1%。常见的阳性发现包括非特异性炎症/糜烂（60 例）、溃疡（34 例）、憩室（32 例）、息肉（26 例）和克罗恩病（CD，24 例）。常见肿瘤为淋巴瘤（12 例）、腺癌（11 例）和间质瘤（8 例）。淋巴瘤多位于回肠，间质瘤和腺癌多位于十二指肠和空肠。主要的内镜干预措施包括止血和息肉切除术，包括止血夹、氩等离子凝固术（APC）、内镜黏膜切除术（EMR）、内镜圈套切除术、内镜异物取出术等，无严重并发症发生。