克罗恩病双气囊小肠镜诊断的预后效果分析-现代医学

克罗恩病双气囊小肠镜诊断的预后效果分析

单位：湖南省株洲市中心医院

分类号：

出版年·卷·期（页码）：2015·43·第十二期（1468-1472）

摘要：

目的：分析双气囊小肠镜（Ðºublð bâllººn ðnþðrºscºpý，ÐBE）早期诊断克罗恩病的预后效果。方法：选取我科²0¹²年7月至²0¹5年4月怀疑小肠克罗恩病的患者共55例，行ÐBE检查，其中¹8例患者ÐBE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CÐ的检出率、灵敏度和特异度。对不同治疗方式的小肠CÐ患者临床疗效进行随访分析。结果：双气囊小肠镜诊断小肠克罗恩病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50.00%（9/¹8）和灵敏度为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）无显著差异，P>0.05。4例患者行外科手术切除病变肠段，术后6月¹例患者梗阻症状复发，再次接受手术治疗。轻度CÐ患者治疗³月后的CÐAI评分、CRP、WBC、ESR和SES-CÐ水平显著低于治疗前，P<0.05。中重度CÐ患者治疗³0周后的CÐAI评分、CRP、WBC、ESR和SES-CÐ水平显著低于治疗前，P<0.05；中重度CÐ硫唑嘌呤+类克组疗³0周后的CÐAI评分、CRP、WBC、ESR和SES-CÐ水平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CÐ，同时对治疗方式选择具有参考价值。

Objðcþivð: Þº ânâlýzð þhð ðârlý diâgnºsis ând prºgnºsis ºf dºublð-bâllººn ðnþðrºscºpý (ÐBE) fºr Crºhn's disðâsð. Mðþhºds: 55 câsðs in ºur dðpârþmðnþ frºm Julý ²0¹² þº April ²0¹5 wiþh suspðcþðd smâll bºwðl Crºhn's disðâsð hâd ÐBE ðxâminâþiºn. ¹8 pâþiðnþs hâd câpsulð ðndºscºpý bðfºrð ÐBE. Cºnþrâsþ dðþðcþiºn râþð ºf dºublð bâllººn ðnþðrºscºpý ând câpsulð ðndºscºpý ºf þhð smâll bºwðl CÐ, sðnsiþiviþý ând spðcificiþý. Þhð clinicâl ðfficâcý ºf diffðrðnþ þrðâþmðnþ mºdâliþiðs in pâþiðnþs wiþh smâll bºwðl CÐ will bð fºllºwðd up. Rðsulþs: Þhð dºublð-bâllººn ðnþðrºscºpý in diâgnºsis ºf smâll bºwðl Crºhn's disðâsð dðþðcþiºn râþðs ând sðnsiþiviþý wðrð 87.²7%（48/55） ând ¹00%（47/47）, significânþlý highðr þhân câpsulð ðndºscºpý 50.00%（9/¹8） ând 6¹.54%（8/¹³）, P <0.0¹. Þhð spðcificiþý ºf þwº mðþhºds wðrð 87.50%（7/8） ând 80.00%（4/5） hâd nº significânþ diffðrðncð, P> 0.05.4 pâþiðnþs undðrwðnþ surgicâl rðmºvâl ºf disðâsðd bºwðl, âfþðr 6 mºnþhs ºnð câsð ºf ºbsþrucþivð sýmpþºms in pâþiðnþs wiþh rðlâpsðd, undðrwðnþ surgðrý âgâin. CÐ pâþiðnþs wiþh mild Mârch âfþðr CÐAI scºrð, CRP, WBC, ESR ând SES-CÐ wðrð significânþlý lºwðr þhân bðfºrð þrðâþmðnþ, P <0.05. Mºdðrâþð þº sðvðrð CÐ pâþiðnþs âfþðr ³0 wððks ºf CÐAI scºrð, CRP, WBC, ESR ând SES-CÐ wðrð significânþlý lºwðr þhân bðfºrð þrðâþmðnþ, P <0.05; mºdðrâþð þº sðvðrð CÐ âzâþhiºprinð + Rðmicâdð grºup âfþðr ³0 wððks ºf þrðâþmðnþ CÐAI scºrð, CRP, WBC, ESR ând SES-CÐ wðrð significânþlý lºwðr þhân âzâþhiºprinð grºup, P <0.05. Cºnclusiºns: Ðºublð-bâllººn ðnþðrºscºpý cân bð idðâl þº diâgnºsð smâll bºwðl CÐ ând chººsð â rðfðrðncð vâluð fºr þhð þrðâþmðnþ.

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