| 李文杰,张其德,孙仁虎,张 婷,韩树堂.小肠CT及双气囊小肠镜诊断克罗恩病患者的差异性分析[J].,2021,(1):117-120 |
| 小肠CT及双气囊小肠镜诊断克罗恩病患者的差异性分析 |
| Differential Analysis of Small Intestine CT and Double Balloon Enteroscopy in the Diagnosis of Patients with Crohn's Disease |
| 投稿时间：2020-05-07 修订日期：2020-05-31 |
| DOI：10.13241/j.cnki.pmb.2021.01.025 |
| 中文关键词: 克罗恩病 小肠CT 双气囊小肠镜 差异性 |
| 英文关键词: Crohn's disease Small intestine CT Double balloon enteroscopy Difference |
| 基金项目:国家中医临床研究基地业务建设第二批科研计划专项（JDZX2015086）；江苏省中医院院级课题面上项目（Y19047） |
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| 中文摘要: |
| 摘要 目的：探究小肠CT及双气囊小肠镜诊断克罗恩病患者的差异性。方法：选择2017年4月至2019年3月于我院接受治疗的60例克罗恩病患者，分别实施小肠CT及双气囊小肠镜检测，对比两种检测方式对克罗恩病患者诊断准确率及病变范围、病变位置、活动度和并发症的检测差异。结果：CT检出克罗恩病的准确率96.67 %，双气囊小肠镜检出克罗恩病的准确率为93.33 %，其差异无统计学意义(P>0.05)。小肠CT主要表现为肠腔狭窄50例(83.33 %)，肠壁增厚52例(86.67 %)，肠外淋巴结46例(76.67 %)，肠系膜水肿及血管改变21例(35.00 %)，肠外炎症10例(16.67 %)，瘘管3例(5.00 %)，瘘道1例(1.67 %)；双气囊小肠镜表现为环形溃疡、不规则溃疡、环状溃疡等共计46例(76.67%)，阿弗他溃疡22例(36.67%)， 黏膜充血、水肿等26例(43.33 %)，结节样增生6例(10.00 %)，小肠肠腔节段性狭窄16例(26.67 %)，假性息肉9例(15.00 %)；经病理学检测表现为淋巴细胞、中性粒细胞、嗜酸性粒细胞等炎性浸润，淋巴组织及肉芽组织出现增生小肠CT发现肠外炎症、瘘道、瘘管等合计14例，而双气囊小肠镜未发现并发症。结论：相比于双气囊小肠镜，小肠CT能够更为准确的判断克罗恩病患者是否处于炎症状态，也能够更有效的发现肠外并发症的存在，但小肠CT及双气囊小肠镜联合应用监测效果更佳。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the difference between small intestine CT and double balloon enteroscopy in the diagnosis of Crohn's disease. Methods: 60 patients with Crohn's disease who were treated in our hospital from April 2017 to March 2019 were selected, and the small intestine CT and double balloon enteroscopy were performed respectively. The diagnosis accuracy, lesion range, lesion location, activity and complication of Crohn's disease patients were compared between two methods. Results: The detection rate of CT was 96.67 %, which was 93.33 % in the double balloon enteroscopy, no statistically significant difference was found between two methods (P>0.05). The main manifestations detected by CT were intestinal stenosis in 50 cases (83.33 %), intestinal wall thickening in 52 cases (86.67 %), extraintestinal lymph nodes in 46 cases (76.67 %), mesenteric edema and vascular changes in 21 cases (35.00 %), extraintestinal inflammation in 10 cases (16.67 %), fistulous tract in 3 cases (5.00 %), fistula in 1 case (1.67 %). Double-balloon enteroscopy showed ring ulcers, irregular ulcers, ring ulcers in 46 cases (76.67 %), aphthous ulcers in 22 cases (36.67 %), mucosal congestion and edema in 26 cases (43.33 %), nodular hyperplasia 6 cases (10.00 %), intestinal segmental stenosis of small intestine in 16 cases (26.67 %), and pseudopolyps in 9 cases (15.00 %). Inflammatory infiltration of lymphocytes, neutrophils, eosinophils and proliferation of lymphoid tissue and granulation tissue were found in patients with Crohn's disease by pathological examination. 14 cases of extraintestinal inflammation, fistula and fistula were found in small intestine CT, but not in double balloon enteroscopy complication. Conclusion: Compared with double balloon enteroscopy, small intestine CT could more accurately determine whether patients with Crohn's disease were in the state of inflammation, and could more effectively detect the existence of extraintestinal complications, but the combined application of small intestine CT and double balloon enteroscopy had better monitoring effect. |
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