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目的探讨双气囊内镜(DBE)对小肠出血性疾病病因诊断和治疗选择的作用。方法2003年6月至2007年8月在广东省第二人民医院和广州南方医院将临床可疑小肠疾病212例,其中疑有小肠出血患者126例,进行DBE检查,发现出血病灶或相关病变进行标记或活检,并与部分手术结果对照。结果可疑小肠出血患者中DBE检查发现小肠出血病变,检出阳性率为80.2%(101/126)。DBE诊断小肠多发性溃疡(含克罗恩病)42例,回肠憩室25例,小肠肿瘤19例,小肠血管畸形10例以及粪类原线虫病2例,钩虫病3例,其中手术治疗39例,术后病理证实33例。16例患者发现非小肠出血的病变,非小肠出血阳性诊断率为12.7%(16/126),消化道出血总体阳性诊断率为92.8%(117/126)。DBE检查未发现明显异常9例。所有患者均未发生严重不良反应和并发症。结论DBE是目前诊断小肠出血最有效的方法之一,无严重不良反应和并发症,可作为首选检查方法。小肠出血的主要病因是良性溃疡(包括克罗恩病)、憩室、肿瘤,其次是血管畸形和寄生虫感染。
Objective To investigate the effect of double balloon endoscopy (DBE) on the etiological diagnosis and treatment of small intestinal hemorrhagic disease. Methods From June 2003 to August 2007, 212 cases of suspicious small intestine disease were diagnosed in the Second People’s Hospital of Guangdong Province and Guangzhou Nanfang Hospital. Among them, 126 cases were suspected of having small intestinal hemorrhage. DBE examination and hemorrhagic lesions or related pathological changes were marked Or biopsy, and with some surgical results. Results In patients with suspected small intestinal hemorrhage, small bowel bleeding was found by DBE examination. The positive rate was 80.2% (101/126). DBE diagnosis of small intestine multiple ulcers (including Crohn’s disease) in 42 cases, ileal diverticulum in 25 cases, 19 cases of small intestine, small bowel vascular malformation in 10 cases and 2 cases of stool negative nematode, hookworm in 3 cases, of which 39 Cases, 33 cases confirmed pathologically. In 16 patients, non-small intestinal hemorrhage was found. The positive rate of non-small intestinal hemorrhage was 12.7% (16/126). The overall positive rate of gastrointestinal bleeding was 92.8% (117/126). DBE examination found no significant abnormalities in 9 cases. No serious adverse reactions and complications occurred in all patients. Conclusion DBE is one of the most effective methods for the diagnosis of small intestinal bleeding. No serious adverse reactions and complications can be used as the preferred method of examination. The main causes of intestinal bleeding are benign ulcers (including Crohn’s disease), diverticula, tumors, followed by vascular malformations and parasitic infections.