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目的:系统地评价双气囊小肠镜(double-balloon endoscope,DBE)对小肠疾病的诊断率、观察范围、并发症等,探讨其诊断价值和安全性.方法:对怀疑或证实有小肠疾病的1036例患者(男性585例,女性451例)在异丙酚麻醉/镇静状态下进行1202例(经口检查589例,经肛门检查613例,双侧对接检查184例)DBE检查.结果:1202例次的检查中,检查成功率99.2%(1193/1202),小肠病变阳性检出率84.5%(875/1036).小肠疾病的类型前3位的是息肉和肿瘤(391/875;44.7%)、糜烂和溃疡(246/875;28.1%)、血管畸形(52/875;5.94%).平均检查时间78 min±43 min(30-180 min).经口进镜长度231 cm±74 cm,经肛进镜长度176 cm±69 cm,两者比较差异有统计学意义(P<0.05).DBE对不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)的病因诊断中前3位的是糜烂和溃疡(57/218,26.1%)、血管性病变(33/218,15.1%)、息肉和肿瘤(28/218,12.8%).63例小肠肿瘤中45例(45/63,71%)为恶性肿瘤,18例(18/63,29%)为良性肿瘤,以小肠恶性肿瘤为主.小肠肿瘤的内镜诊断与镜下病理诊断准确率为87.5%(63/72).严重并发症11例(11/1202,0.915%),小部分患者术后诉轻微的咽喉不适、肛门部疼痛和腹胀.结论:DBE是一种安全可靠地诊断小肠疾病的检查方法,通过直视下的小肠活检以协助病因学鉴别,应用前景广阔.
OBJECTIVE: To evaluate the diagnostic value and safety of double-balloon endoscope (DBE) for the diagnosis of small intestine disease and its clinical significance.METHODS: To evaluate the diagnostic value and safety of double-balloon endoscope (DBE) One hundred and two patients (585 males and 451 females) underwent DBE in 1202 cases (589 cases of oral examination, 613 cases of anus examination and 184 cases of double-sided docking test) under anesthesia / sedation of propofol.Results: 1202 cases The success rate was 99.2% (1193/1202) and 84.5% (875/1036) for the small intestine type.The polyp and tumor (391/875; 44.7%) were the first three types of small intestine disease , Erosions and ulcers (246/875; 28.1%), vascular malformations (52/875; 5.94%). The average examination time was 78 min ± 43 min (30-180 min) The length of the anal enteroscope was 176 cm ± 69 cm, with significant difference between the two groups (P <0.05). The etiological diagnosis of obscure gastrointestinal bleeding (OGIB) (57 / 218,26.1%), vascular lesions (33 / 218,15.1%), polyp and tumor (28 / 218,12.8%) .Among 45 cases (45/63, 71%) of 63 small intestine tumors were Vicious (18/63, 29%) were benign and malignant tumors of small intestine.The accuracy of endoscopic diagnosis and microscopic pathological diagnosis of small intestine tumor was 87.5% (63/72), and serious complications were found in 11 cases (11 / 1202,0.915%), a small number of patients complained slight throat discomfort, anus pain and abdominal distension after operation.Conclusion: DBE is a safe and reliable method for the diagnosis of small bowel disease, by direct vision under the intestinal biopsy to Assist in the identification of etiology, broad application prospects.