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目的:观察双气囊小肠镜在小肠出血中的病变检出率、病因诊断率、耐受性和安全性,并探讨双气囊小肠镜对小肠出血的内镜下治疗。方法:对2006年3月至2009年11月烟台毓璜顶医院消化内科收治的可疑小肠出血102例患者双气囊小肠镜检查,首选进镜方式分为经口或经肛2种,首选方式检查后未发现病灶者,日后改换进镜方式再行检查。对活动性出血病灶行内镜下止血治疗。结果:双气囊小肠镜的病变检出率为94.12%(96/102),病因诊断率为84.31%(86/102),其中35例检查时见病变活动性出血,行内镜下止血治疗,33例止血成功,内镜止血成功率为94.30%(33/35);在耐受性方面,双气囊小肠镜的耐受性依次为:全麻下经肛进镜、全麻下经口进镜、非麻醉经肛进镜、非麻醉经口进镜。所有患者均未发生严重并发症。结论:双气囊小肠镜对小肠出血具有较高的病变检出率和病因诊断率,并且可行内镜下止血治疗,是一项安全、有效的临床诊疗方法。
OBJECTIVE: To observe the detection rate, etiological diagnosis, tolerance and safety of double-balloon enteroscopy in small intestinal bleeding and to explore the endoscopic treatment of small bowel bleeding with double-balloon enteroscopy. Methods: From March 2006 to November 2009, 102 patients with suspicious small intestinal bleeding admitted to Yantai Yuhuangding Hospital were enrolled in this study. Double-balloon enteroscopy was the first choice in this study. Found lesions, the future change into the mirror way to check again. Endoscopic active bleeding hemostasis treatment. Results: The detection rate of double balloon enteroscopy was 94.12% (96/102), the etiological diagnosis rate was 84.31% (86/102), of which 35 cases were examined with active bleeding, endoscopic hemostasis, 33 cases of successful hemostasis, endoscopic hemostasis success rate was 94.30% (33/35); tolerance, double balloon enteroscopy tolerance were: general anesthesia by the endoscope, under general anesthesia by mouth Mirror, non-narcotic anal into the mirror, non-narcotic by mouth into the mirror. No serious complications occurred in all patients. Conclusions: Double balloon enteroscopy has high detection rate and etiological diagnosis rate of small intestine hemorrhage. It is a safe and effective method for clinical diagnosis and treatment of endoscopic hemostasis.