摘要
目的 探讨双气囊小肠镜对小肠溃疡的病因诊断价值.方法 收集并分析武汉大学人民医院消化内科2010年1月至2016年1月行双气囊小肠镜检查的患者的临床、内镜和病理检查资料,对其中发现小肠溃疡的病因诊断进行回顾性分析.结果 共发现小肠溃疡103例.根据内镜下溃疡形态初步诊断：克罗恩病60例（58.3%）,肠结核19例（18.4%）,不明原因25例（24.3%）;再结合病理、临床及治疗转归最终诊断克罗恩病46例（44.7%）,肠结核19例（18.4%）,淋巴瘤4例（3.8%）,嗜酸性粒细胞肠炎2例（1.9%）,非甾体抗炎药相关肠病2例（1.9%）,小肠腺癌1例（1.0%）,间质瘤1例（1.0%）,缺血性肠病1例（1.0%）,血管畸形1例（1.0%）,过敏性紫癜1例（1.0%）,不明原因25例（24.3%）.双气囊小肠镜诊断克罗恩病确诊率73.3%（44/60）,误诊率10.0%（6/60）;诊断肠结核确诊率14/18,误诊率2/18.结论 小肠溃疡的病因复杂多样,应结合DBE下溃疡形态、内镜及手术病理、临床资料进行综合分析.治疗后复查双气囊小肠镜观察溃疡转归可为诊断提供重要信息.
Objective To assess the value of double balloon enteroscopy （DBE） in etiological diagnosis of small bowel ulcer.Methods The clinical and endoscopic data of patients undergoing DBE at the Department of Gastroenterology, Renmin Hospital of Wuhan University from January 2010 to January 2016 were reviewed.For patients with small bowel ulcer revealed by DBE, the etiologic diagnosis was retrospectively analyzed.Results One hundred and three patients with small bowel ulcer were included in the analysis.The initial diagnosis based on morphology of ulcer was Crohn＆#39;s disease （58.3%, 60/103）, intestinal tuberculosis （18.4%,19/103）, etiology unknown （24.3%, 25/103）.The final diagnosis comprehensively based on pathology, clinical data and disease outcome was Crohn＆#39;s disease （44.7%,46/103）, intestinal tuberculosis （18.4%,19/103）, lymphoma （3.8%,4/103）, eosinophils enteritis （1.9%,2/103）, non-steroidal anti-inflammatory drug enteritis （1.9%,2/103）, adenocarcinoma （1.0%,1/103）, stroma tumor （1.0%,1/103）,ischemic enteritis （1.0%,1/103）, vascular malformation （1.0%,1/103）, Henoch-Schonlein purpura （1.0%,1/103）, etiology unknown （24.3,25/103）.The accurate diagnosis rate and misdiagnosis rate for Crohn＆#39;s disease by DBE were 73.3%（44/60）and 10.0%（6/60）.The accurate diagnosis rate and misdiagnosis rate for intestinal tuberculosis by DBE were 14/18 and 2/18.Conclusion There are diversity and complexity in etiologic diagnosis of small bowel ulcer.The diagnosis should be based on the comprehensive analysis of morphology of ulcer, endoscopic and surgical pathology and clinical data.Follow up of small bowel ulcer by DBE may provide important information for etiologic diagnosis.
出处
《中华全科医师杂志》
2017年第5期361-365,共5页
Chinese Journal of General Practitioners
关键词
诊断
小肠溃疡
双气囊小肠镜
Diagnosis
Small bowel ulcer
double balloon enteroscopy
作者简介
通信作者：赵亮，Email：airmanzha02016@163．com
