单气囊和双气囊小肠镜在小儿小肠疾病中的临床应用：576例回顾性研究
[Clinical application of single-balloon and double-balloon enteroscopy in pediatric small bowel diseases: a retrospective study of 576 cases].
作者信息
Li Can-Lin, You Jie-Yu, Luo Yan-Hong, Ou-Yang Hong-Juan, Liu Li, Zhang Wen-Ting, Duan Jia-Qi, Jiang Na, Zhan Mei-Zheng, Liu Chen-Xi, Zhou Juan, Yuan Ling-Zhi, Zhao Hong-Mei
机构信息
Department of Digestive Nutrition, Hunan Children's Hospital, Changsha 410007, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Jul 15;27(7):822-828. doi: 10.7499/j.issn.1008-8830.2411045.
OBJECTIVES
To evaluate the effectiveness of single-balloon and double-balloon enteroscopy in diagnosing pediatric small bowel diseases and assess the diagnostic efficacy of computed tomography enterography (CTE) for small bowel diseases using enteroscopy as the reference standard.
METHODS
Clinical data from 576 children who underwent enteroscopy at Hunan Children's Hospital between January 2017 and December 2023 were retrospectively collected. The children were categorized based on enteroscopy type into the single-balloon enteroscopy (SBE) group (=457) and double-balloon enteroscopy (DBE) group (=119), and the clinical data were compared between the two groups. The sensitivity and specificity of CTE for diagnosing small bowel diseases were evaluated using enteroscopy results as the standard.
RESULTS
Among the 576 children, small bowel lesions were detected by enteroscopy in 274 children (47.6%).There was no significant difference in lesion detection rates or complication rates between the SBE and DBE groups (>0.05), but the DBE group had deeper insertion, longer procedure time, and higher complete small bowel examination rate (<0.05). The complication rate during enteroscopy was 4.3% (25/576), with 18 cases (3.1%) of mild complications and 7 cases (1.2%) of severe complications, which improved with symptomatic treatment, surgical, or endoscopic intervention. Among the 412 children who underwent CTE, the sensitivity and specificity for diagnosing small bowel diseases were 44.4% and 71.3%, respectively.
CONCLUSIONS
SBE and DBE have similar diagnostic efficacy for pediatric small bowel diseases, but DBE is preferred for suspected deep small bowel lesions and comprehensive small bowel examination. Enteroscopy in children demonstrates relatively good overall safety. CTE demonstrates relatively low sensitivity but comparatively high specificity for diagnosing small bowel diseases.
目的
评估单气囊和双气囊小肠镜在诊断小儿小肠疾病中的有效性，并以小肠镜检查为参考标准，评估计算机断层扫描小肠造影（CTE）对小肠疾病的诊断效能。
方法
回顾性收集2017年1月至2023年12月在湖南省儿童医院接受小肠镜检查的576例儿童的临床资料。根据小肠镜类型将儿童分为单气囊小肠镜（SBE）组（n = 457）和双气囊小肠镜（DBE）组（n = 119），比较两组的临床资料。以小肠镜检查结果为标准，评估CTE诊断小肠疾病的敏感性和特异性。
结果
576例儿童中，274例（47.6%）经小肠镜检查发现小肠病变。SBE组和DBE组的病变检出率和并发症发生率无显著差异（P>0.05），但DBE组插入深度更深、操作时间更长、小肠完整检查率更高（P<0.05）。小肠镜检查期间的并发症发生率为4.3%（25/576），其中轻度并发症18例（3.1%），重度并发症7例（1.2%），经对症治疗、手术或内镜干预后病情好转。在接受CTE检查的412例儿童中，诊断小肠疾病的敏感性和特异性分别为44.4%和71.3%。
结论
SBE和DBE对小儿小肠疾病的诊断效能相似，但对于疑似深部小肠病变和小肠全面检查，DBE更具优势。儿童小肠镜检查总体安全性较好。CTE诊断小肠疾病的敏感性相对较低，但特异性相对较高。
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