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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 prognostic value of double balloon enteroscopy (DBE) in diagnosing Crohn’s disease (CD). Methods: A total of 55 patients with suspicious small bowel CD from July 2012 to April 2015 in our department were enrolled in this study. DBE was performed in 18 patients, and 18 patients underwent endoscopic capsule endoscopy. Comparison of double balloon enteroscopy and capsule endoscopy CD, the detection rate, sensitivity and specificity. The clinical efficacy of different treatment of intestinal CD patients were followed up analysis. Results: The detection rate and the sensitivity of double balloon enteroscopy in the diagnosis of small intestine were 87.27% (48/55) and 100% (47/47), respectively, which were significantly higher than those of 50.00% (9/18) and 61.54% (8/13), P <0.01. The specificity of the two methods were 87.50% (7/8) and 80.00% (4/5) respectively, with no significant difference between the two methods (P> 0.05) .4 patients underwent surgical resection of bowel segment by surgery and 6 months One patient had recurrent obstructive symptoms again undergoing surgery. The CDAI score, CRP, WBC, ESR and SES-CD in patients with mild CD after 3 months of treatment were significantly lower than those before treatment, P <0.05. The CDAI score, CRP, WBC, ESR and SESCD of patients with moderate-severe CD after 30 weeks of treatment were significantly lower than those before treatment, P <0.05; CDAI score, CRP and WBC of patients with moderate-severe CD azathioprine + , ESR and SES-CD were significantly lower than azathioprine group, P <0.05. Conclusions: Double balloon enteroscopy can diagnose small intestine CD more ideally, and has reference value for the choice of treatment modalities.