CAJ | 학술논문

目的评价单气囊小肠镜在小肠疾病诊治过程中的安全性及其临床应用价值.方法回顾2009年4月至2010年7月间采用单气囊小肠镜榆查或治疗的83例患者的临床资料,对准备时间、检查时间、病变检出率及并发症发生率等情况进行总结分析.结果 83例患者包括不明原因消化道出血37例、不明原因慢性腹痛38例、慢性腹泻1例、不明原因发热2例、不完全性肠梗阻5例.共进行了 94次单气囊小肠镜检查,其中46例采用经口进镜,26例采用经肛进镜,11例采用经口+经肛进镜.排除6例内镜下治疗患者,经口进镜检查平均操作时间为29.6 min,经肛进镜为57.1 min.57例发现阳性病灶,总的病变检出率为6 8.7%(57/83),其中不明原因消化道出血阳性检出率为81.1%(30/37),不明原因慢性腹痛阳性检出率为57.8%(22/38),不明原因发热阳性检出率为50.0%(1/2),不完全性小肠梗阻阳性检出率为80.0%(4/5).6例单气囊小肠镜诊断为PeutzJeghers综合征的患者接受了内镜下切除多枚小肠息肉治疗,除1例切除息肉时出现出血外,其余未见与操作相关的并发症.结论单气囊小肠镜是检查小肠疾病的可靠方法,使用简便,操作时间短,有较好的小肠病变检出率,对小肠出血术前定位具有重要的临床价值,可用于小肠疾病的诊断和治疗.
목적 평개단기낭소장경재소장질병진치과정중적안전성급기림상응용개치.방법 회고2009년4월지2010년7월간채용단기낭소장경유사혹치료적83례환자적림상자료,대준비시간、검사시간、병변검출솔급병발증발생솔등정황진행총결분석.결과 83례환자포괄불명원인소화도출혈37례、불명원인만성복통38례、만성복사1례、불명원인발열2례、불완전성장경조5례.공진행료 94차단기낭소장경검사,기중46례채용경구진경,26례채용경항진경,11례채용경구+경항진경.배제6례내경하치료환자,경구진경검사평균조작시간위29.6 min,경항진경위57.1 min.57례발현양성병조,총적병변검출솔위6 8.7%(57/83),기중불명원인소화도출혈양성검출솔위81.1%(30/37),불명원인만성복통양성검출솔위57.8%(22/38),불명원인발열양성검출솔위50.0%(1/2),불완전성소장경조양성검출솔위80.0%(4/5).6례단기낭소장경진단위PeutzJeghers종합정적환자접수료내경하절제다매소장식육치료,제1례절제식육시출현출혈외,기여미견여조작상관적병발증.결론 단기낭소장경시검사소장질병적가고방법,사용간편,조작시간단,유교호적소장병변검출솔,대소장출혈술전정위구유중요적림상개치,가용우소장질병적진단화치료.
Objective To evaluate safety and clinical significance of single balloon enteroscopy (SBE) for small intestinal diseases. Methods Data of 83 patients with suspected or known small intestinal diseases, who underwent SBE from March 2009 to July 2010, were reviewed in terms of preparation time,procedure time, detection rate and complication occurrence. Results The 83 patients included 37 cases of digestive tract bleeding, 38 chronic abdominal pain, 1 chronic diarrhea, 2 fever and 5 incomplete ileus. A total of 94 procedures of SBE were performed, including oral route in 46 patients, anal route in 26 and both routes in 11. Excluding 6 cases with endoscopic therapy, the mean procedure time of oral approach was 29.6 ± 10. 3 min, and that of anal route was 57.1 ± 15.6 min. Abnormalities were detected in 57 ( 68.7% )of the 83 patients, with detection rate of 81.1% (30/37) in digestive tract bleeding with unknown reason,57. 8% (22/38) in chronic abdominal pain of unknown reason, 50. 0% (1/2) in fever of unknown reason and 80. 0% (4/5) in incomplete ileus. Peutz-Jeghers syndrome was diagnosed in 6 patients and endoscopic polypectomy was performed, with complicated bleeding in one patient. No other procedure-related complications were observed. Conclusion SBE is well-tolerated and safe for diagnosis of small intestine diseases,with easy manipulatiou, short procedure time, high detection rate and satisfactory location of intestinal hemorrhagic lesions.