摘要目的 初步评估通过计算外套管向体内的回缩距离以判断双气囊内镜插入深度的准确性.方法 入选对象均为双气囊内镜榆出小肠病灶并经手术证实的患者.在双气囊内镜操作过程中通过累计每次推拉内镜过程中镜身在肠腔中的前行长度或通过计算外套管向体内的回缩距离分别判断双气囊内镜插入深度.最终以手术结果评判两种方法的准确性.结果 通过41例经口和10例经肛检查,双气囊内镜在51例患者中检出病灶并经手术证实.根据传统的镜身前行长度判断法,在经口检查者中发现从屈氏韧带-病灶的平均距离为151(30～310)cm,在经肛检查者中自回盲瓣-病灶的平均距离为100(10～180)cm;而根据外套管向体内的回缩距离判断法,则分别为143(30～320)cm和98(10～200)cm.无论进镜方式如何,上述两种方法判断内镜插入深度与手术结果的平均差别分别为19(0～50)cm和17(0～60)cm,差异无统计学意义(P＞0.05).结论 与传统方法相比,通过外套管向体内的回缩距离判断双气囊内镜插入深度的方法同样准确而更为简便,适合临床推广应用.

abstractsObjective The aim of this study was to evaluate the accuracy of calculating the insertion length of the overtube for estimating the insertion depth of the scope at double-balloon enteroscopy (DBE).Methods Patients with intestinal lesions found at DBE and confirmed by surgery were included. The advancing distance of the enteroscope at DBE was estimated by either cumulative length of push/pull cycle or calculation of the overall insertion length of the overtube. The accuracy of these two methods was evaluated with reference to surgery. Results Data from 51 patients who had their lesions found at DBE and treated by surgery were included in the study. DBE included 41 antegrade and 10 retrograde procedures. The average difference in the evaluation of the length of enteroscopic insertion between the two methods was 17 cm ( range 0-60 cm) on antegrade DBE and 12 cm (range 0-30 cm) on retrograde DBE. Furthermore, regardless of insertion route of DBE procedure, the mean differences between the insertion length evaluated by the two methods and surgical findings were 19 cm (range 0-50 cm) and 17 cm (range 0-60 cm), respectively, which was not significantly different ( P ＞ 0. 05 ). Conclusion The new method of calculating the length of the overtube passage is the same accurate and much simpler than the traditional method in estimating the insertion depth of the enteroscope at DBE, which is appliable in clinical practice.