气囊辅助式小肠镜在诊断Meckel憩室中应用价值
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南京医科大学第一附属医院

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国家自然科学基金项目(面上项目,重点项目,重大项目)


The value of balloon-assisted small enteroscopy in the diagnosis of Meckel’s diverticulum
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First Affiliated Hospital of Nanjing Medical University

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    摘要:

    目的:探讨气囊辅助式小肠镜及其他不同检查方法对小肠Meckel憩室的诊断价值。方法:回顾性分析2010年1月至2023年12月于南京医科大学第一附属医院确诊为Meckel憩室的87例患者,收集患者的一般资料、临床表现、诊断方法、治疗及病理结果等资料,总结归纳Meckel憩室患者的临床特征,比较气囊辅助式小肠镜与其他检查方法对小肠Meckel憩室的诊断价值。结果:共纳入87例小肠Meckel憩室患者,55例患者合并消化道出血、肠梗阻、憩室炎、肠穿孔等并发症。与无并发症患者相比,Meckel憩室伴并发症患者中位年龄较小(29(34):49.5(34),P=0.003),憩室直径更长(5.2±2.6:3.3±1.4,P=0.001),开口更宽(2.4±1.1:1.6±0.7,P=0.002),手术率也更高(89.1%(49/55):56.3%(18/32),P=0.000)。不同检查方法对Meckel憩室的诊断灵敏度分别为:腹部CT 8.2%(4/49);小肠CT 9.4%(3/32);数字减影血管造影0.0%(0/9);核素显像(异位胃粘膜显像) 58.3%(7/12);胶囊内镜30.0%(3/10);气囊辅助式小肠镜94.4%(34/36)。结论:年轻患者、憩室直径长、开口宽的小肠Meckel憩室更易合并憩室炎、穿孔、出血、梗阻等并发症。气囊辅助式小肠镜对Meckel憩室的术前诊断价值最高,应作为疑诊小肠Meckel憩室患者首选的检查方法。

    Abstract:

    Objective: To investigate the diagnostic value of balloon-assisted small enteroscopy and other examination methods for Meckel’s diverticulum of the small intestine. Methods: A retrospective analysis was conducted on 87 patients who were diagnosed with Meckel’s diverticulum at the First Affiliated Hospital of Nanjing Medical University between January 2010 and December 2023. Data regarding demographics, clinical presentations, diagnostic methods, treatments, and pathological findings were collected. We summarized the clinical characteristics of patients with Meckel’s diverticulum and compared the diagnostic efficacy of balloon-assisted small enteroscopy with other diagnostic methods for detecting Meckel’s diverticulum. Results: A total of 87 patients with Meckel’s diverticulum were included, with 55 patients presenting complications such as gastrointestinal bleeding, intestinal obstruction, diverticulitis, and intestinal perforation. Patients with Meckel’s diverticulum and complications exhibited a younger median age (29(34): 49.5(34), P=0.003), larger diverticulum diameter (5.2±2.6: 3.3±1.4, P=0.001), wider openings (2.4±1.1: 1.6±0.7, P=0.002), and a higher likelihood of undergoing surgery (89.1%(49/55): 56.3%(18/32), P=0.000) compared to those without complications. The diagnostic sensitivity of different examination methods for Meckel’s diverticulum was as follows: abdominal CT 8.2%(4/49); CT enterography 9.4%(3/32); digital subtraction angiography 0.0%(0/9); nuclide imaging (ectopic gastric mucosal imaging) 58.3%(7/12); capsule endoscopy 30.0%(3/10); and balloon-assisted small enteroscopy 94.4% (34/36). Conclusion: Meckel’s diverticulum in young patients, characterized by a long diverticulum diameter and wide openings, is more prone to complications such as diverticulitis, perforation, bleeding, and obstruction. Balloon-assisted small enteroscopy emerges as the most reliable preoperative diagnostic modality for Meckel’s diverticulum and should be the preferred examination for patients with suspected Meckel’s diverticulum.

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  • 收稿日期:2024-03-09
  • 最后修改日期:2024-04-30
  • 录用日期:2024-08-30
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