CAJ | 학술논문

目的探讨双气囊小肠镜在老年患者中的应用. 方法分析我院老年患者42例和非老年患者73例临床表现、小肠镜特点,并分析老年患者小肠出血阳性病变检出组的特征及出血后小肠镜合适的检查时机. 结果老年组小肠镜检查的完成率为85.7％,与非老年组79.5％比较,差异无统计学意义(P＞0.05),检查时间无明显延长,无严重的并发症.老年组共检出病变30例(71.4％),小肠溃疡、肿瘤最多见；老年小肠出血检出阳性病变者较未检出阳性病变者病史长、出血次数多.末次出血后7d内检查者阳性病变检出率(90.0％),明显高于7d后检查者(40.0％). 结论双气囊小肠镜对于老年患者是一种安全、有效地检查手段；老年患者常见的小肠病变是溃疡、肿瘤；对长时间、多次出血患者,应首选小肠镜检查；出血后应在7d内检查,以提高病变检出率.
목적 탐토쌍기낭소장경재노년환자중적응용. 방법 분석아원노년환자42례화비노년환자73례림상표현、소장경특점,병분석노년환자소장출혈양성병변검출조적특정급출혈후소장경합괄적검사시궤. 결과 노년조소장경검사적완성솔위85.7％,여비노년조79.5％비교,차이무통계학의의(P＞0.05),검사시간무명현연장,무엄중적병발증.노년조공검출병변30례(71.4％),소장궤양、종류최다견；노년소장출혈검출양성병변자교미검출양성병변자병사장、출혈차수다.말차출혈후7d내검사자양성병변검출솔(90.0％),명현고우7d후검사자(40.0％). 결론쌍기낭소장경대우노년환자시일충안전、유효지검사수단；노년환자상견적소장병변시궤양、종류；대장시간、다차출혈환자,응수선소장경검사；출혈후응재7d내검사,이제고병변검출솔.
Objective To investigate the diagnostic value of double balloon endoscopy (DBE) in the elderly. Methods Clinical manifestations and endoscopic findings of 42 elderly patients (aged 60-80 years) and 73 young and middle-aged patients (aged 12-59 years) with small bowel lesions were obtained and compared. Factors influencing the diagnostic outcome of DBE in patients with small bowel bleeding were identified,and the optimal check time after the latest bleeding was determined.Results The procedures of 85.7％ (36/42) in the elderly and 79.5％(58/73) in young and middle aged were completed (P＞0.05).There was no significant difference in the procedure time between the two age groups.No severe complications were observed in the elderly group.The overall positive rate by double balloon enteroscopy examination were 71.4 ％ (30/42) and 63.0 ％ (46/73),respectively in the two groups (P＞ 0.05). Ulcer and tumor lesions were the most common findings,and diverticula and angiodysplasia were the second common findings. Longer duration of bleeding and higher number of bleeding episodes were found in the elderly with positive DBE findings than those with negative findings. Positive diagnostic rate was significantly higher when DBE was performed within 7 days than that after 7 days (90％ vs. 40％). Conclusions DBE is a safe,reliable diagnostic modality,especially in the elderly patients with small bowel bleeding in which ulcer and tumor lesions are the most common identifications.DBE is of greater benefit in patients with more bleeding episodes over a long period,and should be performed within 7 days after the last bleeding.