CAJ | 학술논문

目的初步探讨单气囊小肠镜辅助下球囊扩张术治疗克罗恩病伴小肠狭窄的有效性和安全性.方法 7例克罗恩病患者共行10次扩张术,男性4例,女性3例,平均年龄(37.6±13.5)岁.术前均经影像及病理检查确诊克罗恩病伴不同程度肠梗阻,共有8处严重狭窄,6处位于空肠.扩张术采用控制性径向球囊扩张器(CRE)球囊进行逐级扩张,以扩张后内镜可进入远端肠腔为标准.结果球囊扩张术成功率达8/10,小肠狭窄平均直径由治疗前的(4.1±2.5)mm扩张至(10.2±1.5) mm(t=-8.111,P＜0.01),可进镜深度平均达62 cm,2例患者分别扩张2次及3次.所有患者术后腹痛及肠梗阻症状明显缓解,均未出现出血及穿孔等严重并发症.术后平均随访14个月,2例行手术治疗,另2例因症状复发再次行扩张治疗,中位无症状时间为15个月,70％的患者1年内无症状复发.结论依托于单气囊小肠镜的小肠狭窄扩张术是一项内镜治疗新技术,可安全、有效地治疗克罗恩病并发的肠梗阻.
목적 초보탐토단기낭소장경보조하구낭확장술치료극라은병반소장협착적유효성화안전성.방법 7례극라은병환자공행10차확장술,남성4례,녀성3례,평균년령(37.6±13.5)세.술전균경영상급병리검사학진극라은병반불동정도장경조,공유8처엄중협착,6처위우공장.확장술채용공제성경향구낭확장기(CRE)구낭진행축급확장,이확장후내경가진입원단장강위표준.결과 구낭확장술성공솔체8/10,소장협착평균직경유치료전적(4.1±2.5)mm확장지(10.2±1.5) mm(t=-8.111,P＜0.01),가진경심도평균체62 cm,2례환자분별확장2차급3차.소유환자술후복통급장경조증상명현완해,균미출현출혈급천공등엄중병발증.술후평균수방14개월,2례행수술치료,령2례인증상복발재차행확장치료,중위무증상시간위15개월,70％적환자1년내무증상복발.결론 의탁우단기낭소장경적소장협착확장술시일항내경치료신기술,가안전、유효지치료극라은병병발적장경조.
Objective To explore the efficacy and safety of endoscopic balloon dilatation of small bowel stricture in Crohn′s disease with single balloon enteroscopy (SBE).Methods Seven Crohn′s disease patients (four males and three females with a mean age of 37 years) were underwent 10 times dilatation.Before performance,Crohn′s disease with varying degrees of intestinal obstruction was confirmed by image and pathological examinations.There were 8 severe strictures,6 strictures in jejunum.The dilatation was performed step by step with controlled radial expansiondilator (CRE) balloon.After dilatation,the scope could reach the further small bowel was taken as a standard.Results The overall suecess rate was 8 of 10.The average diameter of intestinal stricture was expanded from (4.1 ± 2.5) mm before therapy to (10.2 ±1.5) mm (P＜0.01),and the average distance of the further small bowel that the scope reached was 62 cm.Two patients underwent twice and three times of dilatation.After the performance,all patients′ symptoms of abdominal pain and obstruction relieved obviously and there were no severe complication of bleeding or perforation.After the performance,the average follow-up time was 14 months,two patients were treated by surgery and the other two underwent dilatation treatment again because of the recurrence of symptoms.The median symptom-free time was 15 months and 70％ of patients were without symptom recurrence in one year.Conclusion Endoscopic balloon dilatation of small bowel stricture with SBE is a new technology of endoscopic treatment,which is safe and effective in the treatment of Crohn's diseasecomplicated with intestinal obstruction.