双气囊小肠镜对老年病人小肠疾病诊治的有效性和安全性分析

doi:10.3969/j.issn.1003-9198.2022.09.004

摘要/Abstract

摘要： 目的探讨双气囊小肠镜(double-balloon enteroscopy, DBE)对老年病人小肠疾病的诊断价值。方法回顾性分析2021年1月至2022年5月因疑诊小肠疾病在南京医科大学第一附属医院行DBE检查的418例病人临床资料。按年龄分为中青年组(年龄＜60岁)357例和老年组(年龄≥60岁)61例,比较2组病人DBE的病变检出率、检出病因、内镜治疗情况及并发症。结果消化道出血和腹痛是老年病人行DBE的常见原因,分别占68.9%和14.8%。老年组DBE的总体诊断率为90.1%,与中青年组(93.8%)差异无统计学意义(P=0.251)。不同年龄组检出小肠疾病的病因构成差异有统计学意义(P<0.001)。老年病人常见诊断分别为小肠溃疡及糜烂(41.8%)、血管性病变(18.2%)和小肠肿瘤(12.7%),而中青年病人最常见诊断为克罗恩病(57.1%),小肠溃疡及糜烂(24.5%)和憩室(4.5%)。63.6%(7/11)诊断为血管性病变的老年病人成功予以经DBE内镜下止血治疗。所有病人均未发生严重并发症。结论 DBE对疑诊小肠疾病的老年病人安全、有效,病变检出率高,并且对血管性病变的老年病人具有较高的内镜治疗价值。

关键词: 双气囊小肠镜, 小肠疾病, 诊断, 治疗

Abstract: Objective To evaluate the value of double-balloon enteroscopy (DBE) in the elderly patients with small intestinal diseases. Methods The clinical data of 418 patients with suspected small intestinal diseases who underwent double-balloon enteroscopy in the First Affiliated Hospital of Nanjing Medical University from January 2021 to May 2022 were retrospectively analyzed. The patients were divided into the young and middle-aged group (aged <60 years, n=357) and the elderly group (aged ≥60 years, n=61) . The diagnostic accuracy of DBE, etiology of small bowel disease, endoscopic treatment and complications were compared between the two groups. Results Small bowel bleeding and abdominal pain were the most common reasons for DBE in the elderly patients, accounting for 68.9% and 14.8%, respectively. The diagnostic accuracy was 90.1% in the elderly group,which was similar with that in the young and middle-aged group(93.8%)(P=0.251). The common diseases in the elderly group were intestinal ulcer and erosion (41.8%), vascular malformation (18.2%) and small intestinal tumor (12.7%),compared with Crohn's disease (57.1%), intestinal ulcer and erosion (24.5%) and diverticulum (4.5%) in the young and middle-aged group. The causes of small bowel diseases were significantly different between the two groups(P<0.001). 63.6% (7/11) of the elderly patients diagnosed as vascular malformations were successfully treated with DBE. No severe complications occurred in 418 patients. Conclusions DBE is a safe and effective method for the elderly patients with suspected small intestinal disease and has a high diagnostic accuracy. DBE is valuable for the treatment of vascular malformations in the elderly patients.

Key words: double-balloon enteroscopy, small intestine diseases, diagnosis, treatment

中图分类号:

R443.8

蒋文瑜, 焦春花, 唐娜娜, 张红杰, 马晶晶. 双气囊小肠镜对老年病人小肠疾病诊治的有效性和安全性分析[J]. 实用老年医学, 2022, 36(9): 878-882.

JIANG Wen-yu, JIAO Chun-hua, TANG Na-na, ZHANG Hong-jie, MA Jing-jing. Efficacy and safety of double-balloon enteroscopy in the diagnosis and treatment of small intestinal diseases in elderly patients[J]. Practical Geriatrics, 2022, 36(9): 878-882.

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