双气囊小肠镜与胶囊内镜诊断小肠出血病因比较.pdfVIP

2004年 12月第 24卷第 12期 Chin J Dig，Dece—mbe—r 2QQ ， l： ! ： 2 双气囊小肠镜与胶囊内镜诊断小肠出血 病因比较 钟捷 张晨莉 马天乐 金承荣 吴云林 江石湖 【摘要】 目的 比较双气囊小肠镜和胶囊内镜在小肠出血中的诊断准确率和实用价值。方法 24 例原因不明的可疑小肠出血患者分别接受双气囊小肠镜和胶囊内镜检查。双气囊小肠镜首选进镜方式 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。胶囊内镜采用以色 列GIVEN公司产品。2种检查方法分别由专门医师独立操作并诊断，最后进行汇总比较。结果 24例 患者中21例通过小肠镜检查发现病灶，总检出率为87．5％。24例患者行胶囊内镜检查后，有阳性发现 者11例(45．8％)，另 13例无异常发现。双气囊小肠镜检查发现的阳性病灶均经活检病理和手术探查 证实，其病因诊断准确率为87．5％，胶囊内镜诊断准确率为25％。在耐受性评估方面，胶囊内镜和全麻 下经口进镜的耐受性最佳，以后依次为非麻醉经肛方式和非麻醉经口方式。所有小肠镜和胶囊内镜检 查者中未见操作相关的严重不良反应。结论 ①经口和经肛方式结合能使双气囊小肠镜完成对全小肠 的检查。②双气囊小肠镜在不明原因小肠出血的病因诊断方面明显优于胶囊内镜检查。③胶囊内镜在 小肠多节段病变和长段病变的诊断上仍有一定价值。④胶囊内镜和全麻下经口双气囊小肠镜检查是一 项易为患者接受的、安全的检查方法。 【关键词】 双气囊小肠镜；胶囊内镜 、肠出血；病因诊断 Comparative study of double-balloon enteroscopy and capsule endoscopy in etiological diagnosis of small in- testine bleeding ZHONG Jie，ZHANG Chen—li，MA Tian一 ，et a1． Department of Gastroenterology． RuOin Hospital，Shanghai Second Medical University，Shanghai 200025，China 【Abstract】 Objective To evaluate the diagnostic yield and accuracy of double—baloon enteroscopy and capsule endoscopy in patients with obscure smal bowel hemorrhage． Methods Twenty—four patients with obscure smal bo wel hemorrhage were performed double—balon enteroscopy and wireless capsule endoscopy separately．The route of enteroscopy could be underwent either via mouth or via anus．Negative result of initial route was required afterwards for another via mouth or via anus examination．Capsule endoscope produced by GIVEN Imaging Company was used．The results of both methods were analyzed independently and final diag— nosis of each case was compared thereafter．Results Totally 2 1 of 24(87．5％)patients had positive findings with enterosoepy．while 11 of 24(45 8％)patients had positive findings with capsule endoscopy．The etio— logical diagnosis of enteroscopy in al cases was confirm ed by surgical exploration and pathological examination with the accuracy of 87．5％，however，the accuracy of capsule endoscopy was only 25％ (6 cases)．On as— sessment of