CAJ | 학술논문

目的评价双气囊内镜和胶囊内镜对小肠出血的临床诊断价值.方法比较双气囊内镜、胶囊内镜及全消化道造影对小肠出血病灶的总体检出率;通过自身对照,比较双气囊内镜和胶囊内镜对小肠出血诊断率;分析胶囊内镜对1次双气囊内镜检查明确诊断率的影响.结果 105例小肠出血患者中,双气囊内镜检出克罗恩病24例,腺癌15例,慢性非特异性炎症12例,不明原因小肠溃疡10例,小肠间质肿瘤8例,小肠息肉8例,小肠血管畸形出血6例,钩虫病5例,麦克尔憩室及多发憩室5例,小肠淋巴瘤3例,无明显异常9例,阳性率91.4%(96/105).其中40例进行胶囊内镜检查,病变检出率75.0%(30/40);75例患者全消化道造影检查,病变检出率33.3%(25/75).根据胶囊内镜结果1次双气囊内镜检查明确诊断率90.0%(36/40),而根据临床特征及消化道造影结果1次双气囊内镜检查明确诊断率69.2%(45/65).结论小肠疾病的主要病因是小肠良性溃疡(包括克罗恩病)、肿瘤、慢性炎症,其次是息肉、血管畸形、寄生虫感染、麦克尔憩室及淋巴瘤等.双气囊内镜对小肠出血诊断率高于胶囊内镜,胶囊内镜能提高1次双气囊内镜明确诊断率.
목적 평개쌍기낭내경화효낭내경대소장출혈적림상진단개치.방법 비교쌍기낭내경、효낭내경급전소화도조영대소장출혈병조적총체검출솔;통과자신대조,비교쌍기낭내경화효낭내경대소장출혈진단솔;분석효낭내경대1차쌍기낭내경검사명학진단솔적영향.결과 105례소장출혈환자중,쌍기낭내경검출극라은병24례,선암15례,만성비특이성염증12례,불명원인소장궤양10례,소장간질종류8례,소장식육8례,소장혈관기형출혈6례,구충병5례,맥극이게실급다발게실5례,소장림파류3례,무명현이상9례,양성솔91.4%(96/105).기중40례진행효낭내경검사,병변검출솔75.0%(30/40);75례환자전소화도조영검사,병변검출솔33.3%(25/75).근거효낭내경결과1차쌍기낭내경검사명학진단솔90.0%(36/40),이근거림상특정급소화도조영결과1차쌍기낭내경검사명학진단솔69.2%(45/65).결론 소장질병적주요병인시소장량성궤양(포괄극라은병)、종류、만성염증,기차시식육、혈관기형、기생충감염、맥극이게실급림파류등.쌍기낭내경대소장출혈진단솔고우효낭내경,효낭내경능제고1차쌍기낭내경명학진단솔.
Objective To study the diagnostic value of double-balloon endoscopy (DBE) and capsule endoscopy (CE) for small intestinal bleeding. Methods Overall detection rates of small intestinal bleeding with DBE, CE and the whole alimentary tract barium meal were compared. Positive rates of bleeding detection with DBE and CE were compared within the same patients. Influence of CE on one-procedure rate of DBE was analyzed. Results In 105 cases of small intestine bleeding, DBE detected 24 cases of Crohn's disease, 15 adenocarcinoma, 12 chronic nonspecific inflammation, 10 small intestinal ulcer of unknown reason, 8 entero-mesenchymoma, 8 polypus, 6 vascular deformation hemorrhage, 5 ancylostomiasis, 5 Mechel's diverticula ( including multiple diverticula), 3 lymphoma and 9 of no evident abnormalities. The positive detection rate of DBE is 91.4% (96/105). Disease detection rates of CE and whole alimentary tract barium meal were 75.0% (30/40) and 33.3% (25/75), respectively. The one-procedure rate of DBE is 90% (36/40) based on CE results, but it was only 69. 2% (45/65) according to clinic features and the whole alimentary tract barium meal. Conclusion The main causes of small intestinal bleeding are benign ulcers (including Crohn's disease) and tumor, as well as chronic inflammation. Polyps, vascular deformation, parasitosis, Mechel's diverticulum and lymphoma are the secondary causes.DBE is superior to CE in diagnosis of small intestine bleeding, but CE can increase the one-procedure rate of DBE.