摘要
目的:分析双气囊小肠镜(DBE)诊断克罗恩病(CD)的预后效果。方法:选取我科2012年7月至2015年4月怀疑小肠CD的患者共55例,行DBE检查,其中18例患者DBE前行胶囊内镜检查。对比双气囊小肠镜和胶囊内镜检查小肠CD的检出率、灵敏度和特异度。对不同治疗方式的小肠CD患者临床疗效进行随访分析。结果:双气囊小肠镜诊断小肠CD的检出率和灵敏度分别为87.27%(48/55)和100%(47/47),显著高于胶囊内镜的50.00%(9/18)和61.54%(8/13),P<0.01。两种检查方法特异度分别为87.50%(7/8)和80.00%(4/5),差异无统计学意义,P>0.05。4例患者行外科手术切除病变肠段,术后6个月1例患者梗阻症状复发再次接受手术治疗。轻度CD患者治疗3个月后的CDAI评分、CRP、WBC、ESR和SES-CD显著低于治疗前,P<0.05。中重度CD患者治疗30周后的CDAI评分、CRP、WBC、ESR和SESCD显著低于治疗前,P<0.05;中重度CD硫唑嘌呤+类克组治疗30周后的CDAI评分、CRP、WBC、ESR和SES-CD显著低于硫唑嘌呤组,P<0.05。结论:双气囊小肠镜可较为理想地诊断小肠CD,同时对治疗方式选择具有参考价值。
Objective： To analyze the diagnosis and prognosis of double-balloon enteroscopy（ DBE） for Crohn＇s disease（ CD）. Methods： 55 cases in our department from July 2012 to April 2015 suspected small bowel CD examined by DBE. 18 patients had examined by capsule endoscopy before DBE. The detection rate of DBE and capsule endoscopy of the small bowel CD,sensitivity and specificity were compared. The clinical efficacies of different treatment modalities in patients with small bowel CD were followed up and analyzed. Results： The small bowel CD detection rates and sensitivity of DBE were 87. 27%（ 48 /55） and 100%（ 47 /47）,significantly higher than those of capsule endoscopy（ 50. 00%（ 9 /18） and 61. 54%（ 8 /13））,P 0. 01. The specificities of two methods were 87. 50%（ 7 /8） and 80. 00%（ 4 /5）,and they had no significant difference,P 0. 05. 4 patients underwent surgical removal of diseased bowel,after 6 months one case relapsed obstructive symptoms,which underwent surgery again. CDAI score,CRP,WBC,ESR and SES-CD of mild CD patients were significantly lower3 months after treatment than those before treatment,P 0. 05. CDAI score,CRP,WBC,ESR and SES-CD of moderate to severe CD patients 30 weeks after treatment were significantly lower than those before treatment,P 0. 05; CDAI score,CRP,WBC,ESR and SES-CD of moderate to severe CD patients in azathioprine ＋ remicade group 30 weeks after treatment were significantly lower than those in azathioprine group,P 0. 05. Conclusion：DBE can be ideal to diagnose small bowel CD and it has a reference value for the choice of treatment.
出处
《现代医学》
2015年第12期1468-1472,共5页
Modern Medical Journal
关键词
双气囊小肠镜
克罗恩病
胶囊内镜
double-balloon enteroscopy
Crohn＇s disease
capsule endoscopy
作者简介
罗虹雨（1969-），女，贵州大方人，主任医师。E-mail：717957881@qq．com
