急诊肠镜检查在小肠出血患者治疗中的应用价值及安全性分析

Analysis of the application value and safety of emergency enteroscopy in the treatment of patients with small bowel bleeding.

作者信息

Zhongcheng Liu, Chao Tang, Dongting Chen, Biyao Wang, Qin Guo

机构信息

Department of Small Bowel Endoscopy, Biomedical Innovation Center, Department of Gastroenterology, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.

Biomedical Innovation Center, the Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

出版信息

Surg Endosc. 2025 Sep 11. doi: 10.1007/s00464-025-12134-0.

DOI:10.1007/s00464-025-12134-0

PMID:40935938

Abstract

BACKGROUND

To explore the value and safety of emergency enteroscopy (EES) in the treatment of patients with small bowel bleeding (SBB), and to analyze the etiological characteristics of SBB patients.

METHODS

We collected the clinical data of 157 patients who were diagnosed as SBB and underwent emergency enteroscopy in the Sixth Affiliated Hospital of Sun Yat-sen University from May 2021 to July 2023, analyzing the results of diagnosis and treatment, as well as the occurrence of complications and follow-up.

RESULTS

A total of 157 patients (119 males and 38 females) were included in the study, aged 7-83 (44.85 ± 17.86) years, and the disease duration was 1-9 (3.20 ± 2.20) days. There were 42 patients who underwent transoral enteroscopy, 29 patients who underwent transanal enteroscopy, and 86 patients who underwent both accesses. The diagnostic rate of EES was 90.4% (142/157). The etiology of SBB was small bowel ulcer (n = 37, 23.60%), small bowel stromal tumor (n = 11, 7.00%), post-surgical anastomotic hemorrhage (n = 20, 12.70%), vascular malformations (n = 23, 14.60%), diverticulum of the small bowel (n = 29, 18.5%), and hemangioma of the small bowel (n = 22, 14.0%). The median follow-up time of SBB patients was (16.38 ± 7.97) months with a range of 8-35 months.

CONCLUSIONS

EES is safe and effective for the diagnosis of SBB and endoscopic treatment. The etiology of SBB is more common with small bowel ulcers, small bowel diverticula, vascular malformations, and hemangiomas.

摘要

背景

探讨急诊小肠镜检查（EES）在小肠出血（SBB）患者治疗中的价值及安全性，并分析SBB患者的病因特征。

方法

收集2021年5月至2023年7月在中山大学附属第六医院被诊断为SBB并接受急诊小肠镜检查的157例患者的临床资料，分析其诊治结果、并发症发生情况及随访情况。

结果

本研究共纳入157例患者（男性119例，女性38例），年龄7 - 83岁（44.85±17.86），病程1 - 9天（3.20±2.20）。经口小肠镜检查42例，经肛门小肠镜检查29例，两种途径均采用86例。EES诊断率为90.4%（142/157）。SBB的病因包括小肠溃疡（n = 37，23.60%）、小肠间质瘤（n = 11，7.00%）、术后吻合口出血（n = 20，12.70%）、血管畸形（n = 23，14.60%）、小肠憩室（n = 29，18.5%）和小肠血管瘤（n = 22，14.0%）。SBB患者的中位随访时间为（16.38±7.97）个月，范围为8 - 35个月。