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目的探讨Peutz-Jeghers综合征患者的临床特征及双气囊小肠镜(double-balloon enteroscopy,DBE)在小肠多发息肉治疗中的应用价值。方法回顾性分析我院2004年11月至2008年10月收治的38例Peutz-Jeghers综合征患者的临床资料,同时应用DBE对该组患者行内镜下小肠息肉切除,主要观察指标包括小肠息肉切除的数量、大小以及与检查治疗相关的并发症等。结果本组38例患者共进行了72例次检查及治疗(经口47次,经肛25次)。本组患者均有小肠多发息肉。共成功切除小肠息肉516枚(直径5～10mm56枚、11～30mm274枚,直径30～60mm153枚,直径60～80mm33枚)。发现息肉癌变2例。术后3d发生慢性小肠穿孔1例,术中急性穿孔1例,3例术后出现消化道出血,导致血红蛋白较基础值下降2g/L以上,但经止血及输血治疗后,出血停止,无其他严重并发症发生。结论DBE是一种相对安全、可靠的切除Peutz-Jeghers综合征患者小肠息肉的方法,具有重要的临床应用价值。
Objective To investigate the clinical features of patients with Peutz-Jeghers syndrome and the value of double-balloon enteroscopy (DBE) in the treatment of multiple small polyps. Methods The clinical data of 38 patients with Peutz-Jeghers syndrome admitted to our hospital from November 2004 to October 2008 were retrospectively analyzed. At the same time, endoscopic polypectomy was performed with DBE. The main observation indicators included small intestine polyp The number of resections, the size and the complications related to the examination and treatment. Results 38 patients in this group conducted a total of 72 times examination and treatment (oral 47 times, anal 25 times). This group of patients have multiple polyps in the small intestine. A total of 516 cases of small intestine polyps were successfully resected (diameter 5 ~ 10mm56, 11 ~ 30mm274, diameter 30 ~ 60mm153, diameter 60 ~ 80mm33). Two cases of polyposis cancer were found. One case of chronic small bowel perforation occurred in 3 days after operation and 1 case of acute perforation occurred in operation. Gastrointestinal hemorrhage occurred in 3 cases after operation, leading to a decrease of 2g / L or more in hemoglobin compared with the baseline value. However, bleeding was stopped after hemostasis and blood transfusion, Serious complications occur. Conclusion DBE is a relatively safe and reliable method for resection of small intestine polyp in patients with Peutz-Jeghers syndrome and has important clinical value.