双球囊内镜的诊断与疗效评估

来源 :世界核心医学期刊文摘(胃肠病学分册) | 被引量 : 0次 | 上传用户:crp123
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Background and study aims: Double-balloon enteroscopy (DBE) is a new endoscopic method for examining the small intestine. Most reports of DBE have been from Japan, and very few data on this new technique have been reported by centers outside Japan. The aim of the present study was to determine the diagnostic yield of DBE, measure the frequency of management changes made on the basis of the results, and evaluate the clinical outcome for patients undergoing the procedure. Patients and methods: All patients undergoing DBE using a Fujinon enteroscope (length 200 cm, diameter 8 mm) during a 11-month period were studied. All of the patients had previously undergone esophagogastroduodenoscopy and colonoscopy. They underwent small-bowel cleansing on the day before the procedure using a standard colon lavage solution. Results: Seventy DBE procedures were carried out in 53 patients (34 men, 19 women; mean age 60 years, range 24-80) by the oral route in 46 cases and the anal route in 24. The indications for the examination were g astrointestinal bleeding (n = 29), suspected Crohn‘s disease (n = 6), abdominal pain (n = 4), polyp removal or evaluation in polyposis syndromes (n = 6), chron ic diarrhea (n = 4), and surveillance or tumor search (n = 4). The mean duration of the procedure was 72 min (range 25 min -3 h). The mean radiation exposure w as 441 dGy/cm (range 70 -1462), and the mean depth of small-bowel insertion wa s 150 cm (range 1 -470 cm). It was possible to evaluate the entire small bowel in four patients (8%). A new diagnosis was obtained in 26 of the 53 patients (4 9%). The findings in the 70 procedures were angiodysplasia (n = 13), ulceration s or erosions (n = 5), jejunitis or ileitis (n = 5), tumors (n = 5), stenosis (n = 4), polyps (n = 5), lymphangiectasias (n = 4), Crohn‘s disease (n = 4), and normal (n = 17). DBE resulted in a therapeutic intervention (endoscopic, medical or surgical, excluding blood transfusions) in 57%of the patients (30 of 53). T he only complication (1.4%) observed was one case of intraprocedural postpolype ctomy bleeding, which resolved with injection of epinephrine. Conclusion: In alm ost two-thirds of the patients examined, DBE was clinically useful for obtainin g a new diagnosis and starting new treatments, changing existing treatments, car rying out surgical intervention, or providing therapeutic endoscopy. DBE is a us eful and safe method of obtaining tissue for diagnosis, providing hemostasis, an d carrying out polypectomy. Background and study aims: Double-balloon enteroscopy (DBE) is a new endoscopic method for examining the small intestine. Most reports of DBE have been from Japan, and very few data on this new technique have been reported by centers outside Japan. The aim of the present study was to determine the diagnostic yield of DBE, measure the frequency of management changes made on the basis of the results, and evaluate the clinical outcome for patients undergoing the procedure. Patients and methods: All patients undergoing DBE using a Fujinon enteroscope (length 200 cm, diameter 8 mm) during a 11-month period were studied. All of the patients had previously undergone esophagogastroduodenoscopy and colonoscopy. They underwent small-bowel cleansing on the day before the procedure using a standard colon lavage solution. Results: Seventy DBE procedures were carried out in 53 patients (34 men, 19 women; mean age 60 years, range 24-80) by the oral route in 46 cases and the anal route in 24. The indi cations for the examination were g astrointestinal bleeding (n = 29), Crohn’s disease (n = 6), abdominal pain (n = 4), polyp removal or evaluation in polyposis syndromes (n = 6), chron ic diarrhea The mean duration of the procedure was 72 min (range 25 min -3 h). The mean radiation exposure w as 441 dGy / cm (range 70 -1462) , and the mean depth of small-bowel insertion wa s 150 cm (range 1 -470 cm). It was possible to evaluate the entire small bowel in four patients (8%). A new diagnosis was obtained in 26 of the 53 patients (49%). The findings in the 70 procedures were angiodysplasia (n = 13), ulceration s or erosions (n ​​= 5), jejunitis or ileitis (n = 5), tumors 4), polyps (n = 5), lymphangiectasias (n = 4), Crohn’s disease (n = 4), and normal transfusions) in 57% of the patients (30 of 53). T he o nlycomplication (1.4%) observed was one case of intraprocedural postpolype ctomy bleeding. which resolved with injection of epinephrine. Conclusion: In alm ost two-thirds of the patients examined, DBE was clinically useful for obtainin ga new diagnosis and starting new treatments, changing existing treatments, car rying out surgical intervention, or providing therapeutic endoscopy. DBE is a us eful and safe method of obtaining tissue for diagnosis, providing hemostasis, an d carrying out polypectomy.
其他文献
6月5日晴生活不可能一帆风顺,人生难免会遇到挫折,我想每个人都经历过失败吧。面对失败,你选择逃避还是去面对?这取决于你如何看待失败,弱者只会在失败面前消沉下去,强者会从
期刊
生物课堂教学依据新课标结合高效课堂的要求,发生了很大的变化,课堂教学由传统教学模式向高效课堂的教学模式转变。生物课所涉及的内容抽象复杂,涉及面广、难以理解。因此,教
“华盛顿共识”所隐含的原理可以这样形容 :把发展混同于无限度的经济增长 ;把社会进步的目标简化为“滴答”效应 ;尽可能多地参与国际贸易是发展的基本先决条件 ;政府的角色
6月5日晴近日,我有幸与初一同学们一起参加了为期两天的秦台拓展训练,两天的训练不长,但对我们的成长却意义不同寻常。“毕业墙”是我们所有同学要共同完成的最后一项挑战。
从戈尔的褐色西装帅不帅,哈里斯脸上搽的粉底厚几英寸,到布什选举后的龙颜大怒威不威,美国2000年的大选后,社会上充满对参选者的长相、包装和仪态的评头品足。盖洛普民意调
生殖器疱疹的反复发作可能与患者T淋巴细胞功能异常有关[1].为探讨CD4+CD25+调节性T细胞在复发性生殖器疱疹(RGH)发病机制中的作用,我们采用免疫荧光三标记流式细胞仪检测18例RGH患者外周血CD4+CD25+调节性T细胞在发作期及静止期的动态变化,并探讨其意义。
课堂提问是一项设疑、激趣、引思的综合性艺术,是高中美术鉴赏课常用的教学方式,课堂提问运用得好,能够激发学生的学习兴趣,唤醒学生的求知欲,有效提升教学质量。因此,教师必
1病历摘要男,32岁。因间断性腹胀、乏力10a,加重15d于2009-03-15就诊,查体神情,皮肤、黏膜无黄染,可见肝掌,肝区叩击轻度不适,神经系统无阳性体征。家族中无癫痫;肝功:ALT189
在现实世界里,客体的实体与属性是统一的。文章认为,通过虚拟技术,可以实现实体与属性的相对分离。这种分离,其实是以虚拟技术为中介在信息意义上实体属性的实现。这一实现使
生物是一门实验性科学,很多结论都是通过观察得到的,所以,生物教学要扣紧观察这一主脉搏,让学生在观察中认识生物、学习生物。1.生物观察要有明确的目的。观察其实是一种有目