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目的分析双气囊小肠镜(DBE)检查阴性患者的临床特点。方法对武汉大学人民医院消化科2005年12月至2009年7月怀疑小肠疾病的115例患者行DBE检查。其中DBE检查阴性和阳性患者分别为32例和83例,比较两组患者的临床资料。结果 115例患者中检出的小肠病变为83例,总诊断率为72.2%,共2例并发急性胰腺炎,1例发生高淀粉酶血症。DBE检查阴性患者的初始血红蛋白比阳性患者高[(107.938±26.015)g/L对(93.518±32.367)g/L,P=0.016],同时二者在临床症状(不明原因消化道出血、不明原因不全肠梗阻、腹痛待查、腹泻待查)的比较也有统计学意义(12∶6∶11∶3对54∶12∶15∶2,P=0.035)。且其对不明原因消化道出血的阳性检出率(81.8%)明显高于腹痛待查(57.7%)和腹泻待查(40%)患者的检出率。结论 DBE是目前诊断小肠疾病的有效方法 ,然而对于初始血红蛋白较高或以腹痛、腹泻症状为主的患者应慎重选择此检查方法 。
Objective To analyze the clinical features of patients with negative double balloon enteroscopy (DBE). Methods One hundred and fifteen patients suspected of small bowel disease from December 2005 to July 2009 in Department of Gastroenterology, Renmin Hospital of Wuhan University were enrolled in DBE. Among them, 32 cases were negative and 83 cases were positive for DBE. The clinical data of two groups were compared. Results Among the 115 patients, 83 cases were diagnosed as small bowel disease, with a total diagnosis rate of 72.2%. A total of 2 cases complicated with acute pancreatitis and 1 case had hypermylaticosis. The initial hemoglobin score of patients with negative DBE was higher than that of positive patients ([107.938 ± 26.015] g / L vs 93.518 ± 32.367 g / L, P = 0.016], and both of them were significantly higher in clinical symptoms (unexplained gastrointestinal bleeding, Incomplete intestinal obstruction, abdominal pain to be investigated, diarrhea pending investigation) were also statistically significant (12:6:11:3 vs 54:12:15:2, P = 0.035). The positive rate of hemorrhage in patients with unexplained gastrointestinal bleeding (81.8%) was significantly higher than that of abdominal pain (57.7%) and diarrhea (40%). Conclusion DBE is an effective method for the diagnosis of small bowel disease. However, patients with high initial hemoglobin or abdominal pain and diarrhea should be carefully selected.