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双气囊內镜诊断的适应症、检测能力、阳性结果、总肠镜检查和其产生的并发症:对使用的第一个十年的数据进行

发布日期:2014-1-29 12:40:20 文章来源:GIE 作者次数:1283
    双气囊內镜诊断的适应症、检测能力、阳性结果、总肠镜检查和其产生的并发症:对使用的第一个十年的数据进行系统审查
    背景
    双气囊內镜(DBE)用于临床实践已将近10年。
    目的
    系统收集和生成关于双气囊內镜(DBE) 诊断适应症、检出率、总肠镜检查、并发症和阳性结果组合的汇总数据。
    设计
    一项系统的评估。
    主要测量指标
    我们于2001年1月1日至2010年3月31日搜索了PubMed上关于小肠疾病的双气囊內镜(DBE)评估方面的研究文章。提取并/或计算关于手术总数适应症分布汇总检出率、合并的总肠镜检查率和阳性结果组合的相关数据。此外,还对双气囊內镜(DBE)相关并发症进行了分析。
    结果
    本研究共包括66篇英文研究文章和12823个程序。疑似中消化道出血(MGIB)是最常见适应症,占62.5%,紧跟着为7%的仅有症状/体征,5.8%的小肠梗阻和5.8%的克罗恩病。对总体、疑似中消化道出血(MGIB)、仅有症状/体征、克罗恩病和小肠梗阻的汇总检出率分别为68.1%,68.0%,53.6%,63.4%和85.8%。在东西方国家中疑似中消化道出血(MGIB)患者检查中,最常见的结果分别是炎症性病变(37.6%)和血管病变(65.9%)。通过联合或单顺行方法合并的总肠镜率为44.0%。合并的次要和主要并发症发生率分别为9.1%和0.72%。
    局限性
    纳入和排除标准定义松散。
    结论
    双气囊內镜诊断的检查能力和并发症发生风险是人们可以接受的。疑似中消化道出血是最常见的适应症,而且对它有较高的检出率,但是在东西方国家之间其病因存在差异。
    缩写词 DBE为双气囊內镜,MGIB为终消化道出血
     
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    Indications, detectability, positive findings, total enteroscopy, and complications of diagnostic double-balloon endoscopy: a systematic review of data over the first decade of use
    Background
    Double-balloon endoscopy (DBE) has been used in clinical practice for nearly 10 years.
    Objective
    To systematically collect and produce pooled data on indications, detection rate, total enteroscopy, complications, and the composition of positive findings in diagnostic DBE.
    Design
    A systematic review.
    Main Outcome Measurements
    We searched PubMed between January 1, 2001 and March 31, 2010 for original articles about DBE evaluation of small-bowel diseases. Data on total number of procedures, distribution of indications, pooled detection rate, pooled total enteroscopy rate, and composition of positive findings were extracted and/or calculated. In addition, the data involving DBE-associated complications were analyzed.
    Results
    A total of 66 English-language original articles involving 12,823 procedures were included. Suspected mid-GI bleeding (MGIB) was the most common indication (62.5%), followed by symptoms/signs only (7.9%), small-bowel obstruction (5.8%), and Crohns disease (5.8%). The pooled detection rates were 68.1%, 68.0%, 53.6%, 63.4%, and 85.8% for overall, suspected MGIB, symptoms/signs only, Crohns disease, and small-bowel obstruction, respectively. Inflammatory lesions (37.6%) and vascular lesions (65.9%) were the most common findings, respectively, in suspected MGIB patients of Eastern and Western countries. The pooled total enteroscopy rate was 44.0% by combined or antegrade-only approach. The pooled minor and major complication rates were 9.1% and 0.72%, respectively.
    Limitations
    Inclusion and exclusion criteria were loosely defined.
    Conclusion
    The detectability and complication risk of diagnostic DBE are acceptable. Suspected MGIB is the most common indication, with a relatively high detection rate, but there was a difference in its causes between Western and Eastern countries.
     
     
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