双气囊小肠镜检查联合小肠CT造影在小肠疾病中的诊断价值

Diagnostic value of double balloon enteroscopy combined with small intestine computed tomography enterography in intestinal diseases

摘要:

目的 探讨双气囊小肠镜（DBE）联合小肠CT造影（CTE）检查在小肠疾病中的诊断价值。方法 纳入不明病因的小肠疾病患者65例，均进行CTE和DBE检查，分析DBE、CTE及两者联合检查对病因的检出率。结果 在不明原因消化道出血、消瘦和腹痛患者中，DBE检出率均优于CTE（P < 0.01），联合检查检出率均优于CTE或DBE单项检查（P < 0.01）；对不明原因腹胀的患者，联合检查检出率与DBE单项检查相当，均优于CTE（P < 0.01）。ROC曲线提示联合检查检出率更高。结论 对于不明原因消化道出血的患者，可优先选择DBE或两者联合；对于怀疑肠腔占位或者狭窄的患者，应优先行CTE检查。根据患者情况联合应用DBE和CTE有优势互补作用，能极大地提高小肠疾病的诊断率。

Abstract:

Objective To explore the diagnostic value of double balloon enteroscopy (DBE) combined with computed tomography enterography (CTE) in intestinal diseases.Methods Sixty-five patients with intestinal diseases of unknown etiology were included, and CTE and DBE examinations were performed to analyze the detection rate of the etiology by DBE, CTE and their combined examinations.Results In patients with unexplained gastrointestinal bleeding, wasting and abdominal pain, DBE was superior to CTE (P < 0.01). The combined examination was better than the single examination of CTE or DBE (P < 0.01). For patients with unexplained abdominal distension, the detection rate of combined examination was the same as that of single examination of DBE, both of which were better than that of CTE (P < 0.01). ROC curve indicated that the combined detection rate was higher.Conclusion For patients with unexplained gastrointestinal bleeding, DBE or a combination of the two can be preferred. For patients with suspected intestinal space occupation or stenosis, CTE in small intestine is preferred. Combined application of DBE and CTE can complement each other according to the patient's situation, which can greatly improve the diagnosis rate of intestinal diseases.