| Objective: Middle enteron is specially the digestive tract betweenTreitz ligaments and ileal valve. Since middle enteron is very long, it is locatedspecially, bending as well as freeing, and gastroscope and enteroscope can’treach, therefore, there’re many traditional detective methods, however, thesensitivity and specificity are very low. Iconography test such as barium meal,DSA angiography, abdomen CT and MRI and so on can not get direct images,which have many disturbance factors, low sensitivity, so that traditionalmethods may have been left far behind. Generally, middle enteron disease hasnot much obvious specificity, clinical manifestation is various, such asobliterate reason bleeding, Abdominal Pain, diarrhea and so on. There are manykinds of diseases including blood vessel disease, intestine cancer, diverticulum,Inflammation disease, immune disease as well as other such as NSAIDSenteropathy, mesentery blood vessel embolism. middle enteron is always theblind zone of alimentary canal, because of the limitation of detective method,middle enteron disease is always not diagnosis correctly, and there is alwaysmissed diagnosis, Diagnostic Error, and eligible therapeutics time is oftenaffected adversely. All the time, the diagnosis of middle enteron disease is a bigproblem to doctors. BE and CE become more and more popular to visuallydetect alimentary canal diseases, and which make middle enteron diseasediagnosis better and better. However, CE and BE both have their characters,advantages, as well as shortcomings. So far Clinical Medicine society has not reached a consensus and unified standard of detective method on middleenteron disease. If we can detect diseases by economical, suitable method, notonly could the state of an illness be controlled effectively, but also the patient’seconomic burden could be greatly released. In the thesis the researcher willcompare the detection rate, diagnosis rate, tolerance and safety CE and BE onmiddle enteron disease, and their combination diagnosis effectiveness, whichcan improve detective rate and diagnosis rate,and direct the diagnosis ofalimentary canal diseases. Methods: firstly we choose35patients withdistrustful middle enteron disease, they must satisfy some test requirements, atfirst they will receive CE test, and then receive BE test on the previous CE test,at last we do some statistical analysis to the detective results.25cases in CEdetect are positive, and then according to the results the researcher did SBEdetect through mouth or anus;10cases negative could be detected by SBEthrough mouth or anus according to clinical symptom and other detect results, ifno lesion is detected, then through the other side, if it is not evaluated, thendetecting u mouth should be firstly chosen. CE and SBE detection should beoperated by professional doctors independently, and then summary andanalyzing it. The results are analyzed to compare CE and SBE, as well as thevalue of both combinations detection on middle enteron disease. Results:(1)the detect results could be classified into following several kinds: positive(theclinical symptom could be soundly explained by detected disease focus, forexample, big ulcer and fresh blooding), distrustful positive(the clinicalsymptom could not be soundly explained by detected disease focus, for example, small polyp of stomachache patients), and negative(no obviousabnormality detected). The percentage of sum of positive cases and distrustfulpositive cases with total cases is called detective rate of disease.(2) last resultsare that: first,17cases of both are positive, and have same diagnosis results;second,5cases are both positive but have different diagnosis results; third,5cases have different diagnosis results, negative by CE while positive by SBE;fourth,3cases are positive by CE while negative by SBE; fifth,5cases of bothare negative. In the test the total detective rate of CE and SBE are respectively71.43%and77.14%, diagnosis rat respectively53.33%and75.67%, which isnearly coincided with previous literatures. Detective rate of both is verycontiguous, and the differences are not significant at statistical level, while thediagnosis rate of SBE is higher than CE.(3) Operating through mouth or anusis critical to improve positive detect for SBE. Detecting by SBE before CEdetect is more effective because of the direction of CE result. For example, in25positive cases by CE,15cases are detected by SBE basing on CE resultsthrough mouth or anus, and13cases are detected positive, positive rate is86.70%; of10cases not specifically located,5cases are detected positivethrough mouth firstly, positive rate is41.67%. The difference of both issignificant at statistical level. The combination detects improve the detect rateand diagnosis rate of SBE. Conclusion:(1) Operating through mouth or anus iscritical to improve positive detect for SBE. And a combination detects improvethe detect rate and diagnosis rate of SBE. Because the results of CE detectcould direct SBE detect; final diagnosis could be reached by Biopsy inspected through SBE if the patient could not be diagnosis by CE detect.(2) The detectrate of multiple segments lesions is higher by CE, while that of single orisolated lesions is much lower, such as intestine cancer, diverticulum,abnormalities and so on. For patients with suspected cancer, SBE is suggested.On the other hand, for usual health examination, CE is suggested. If possible,diagnosis by both combination detect is advised, which could improve thediagnosis effectiveness of middle enteron disease. |
