The Application Value Of Single Balloon Enteroscopy In Unexplained Abdominal Pain

Objective:Single balloon enteroscopy has been widely used in clinical practice.The purpose of this study was to compare the tolerance of patients undergoing single balloon enteroscopy under intravenous anesthesia and diazepam sedation,and to evaluate the application value of single balloon enteroscopy in unexplained abdominal pain.Methods:190 patients with unexplained abdominal pain admitted to the department of gastroenterology of Yantai Affiliated Hospital of Binzhou Medical University from June 2015 to Feb 2019 and underwent single-balloon enteroscopy were retrospectively analyzed.95 patients completed the examination by using dizocine combined with propofol intravenous anesthesia,and 95 patients completed the examination by using the pretest intravenous injection of diazepam 10mg sedation,respectively defined as the intravenous anesthesia group and the awake sedation group,two groups of patients with no significant statistical differences in gender,age(P>0.05).By comparing the operation time,lesion detection rate,diagnosis rate,disease type,microscopic treatment,operation-related adverse reactions and tolerance of the two groups,the diagnosis and treatment value of Single balloon enteroscopy in unexplained abdominal pain was evaluated.Results:A total of 118 examinations were performed on 95 patients in the intravenous anesthesia group,including oral route in 17 patients,anal route in 55 and both routes in 23,the mean procedure time of oral approach was39.60±7.59 min,and that of anal route was 48.76 ± 8.49 min.A total of 117 examinations were performed on 95 patients in the awake sedation group,including oral route in 25patients,anal route in 48 and both routes in 22,the mean procedure time of oral approach was50.24±8.50 min,and that of anal route was 61.87±7.65 min.In the two groups,the operation time of transoral examination was significantly less than that of transanal examination,and the average operation time of transoral and transanal examination in the intravenous anesthesia group was significantly less than that of the awake sedation group(P<0.05).A total of 78 patients in the intravenous anesthesia group were found pathological changes under the microscope,with a detection rate of 82.11%(78/95),diagnosis rate of 68.42%(65/95),In the awake sedation group,pathological changes were observed under the microscope in a total of 73cases,with a detection rate of 76.84%(73/95),diagnosis rate of 70.53%(67/95).There was no significant difference in the detection rate and diagnosis rate between the two groups(P>0.05).The main types of small intestinal diseases diagnosed in the two groups were non-specific intestinal erosion,non-specific intestinal ulcer,crohn's disease and small intestinal adenoma.In the intravenous anesthesia group,the proportions of various small intestinal diseases were Nonspecific intestinal erosion in 32 cases(33.68%),Nonspecific small intestinal ulcer in 19 cases(20.00%),Crohn's disease in 7 cases(7.37%),adenoma in 6 cases(6.32%),adenocarcinoma in 4 cases(4.21%),intestinal tuberculosis,P-J syndrome,Small intestinal lymphangiectasis,Yellow melanoma and Small intestinal stromal tumor in 2 case(2.11%).In the awake sedation group,30 cases(31.58%)had Non-specific intestinal erosion,18 cases(18.95%)had Non-specific small intestinal ulcer,8 cases(8.42%)had Crohn's disease,5 cases(5.26%)had adenoma,Small intestinal stromal tumor and intestinal tuberculosis in 3 case(3.16%),Small intestinal lymphangiectasis,Yellow melanoma and adenocarcinoma in 2 case(2.11%).Patients in the awake sedation group had more serious abdominal distension,abdominal pain,nausea and other conditions during the examination,and the degree of cooperation was poor.The abdominal distension and abdominal pain after the examination were also more serious than those in the intravenous anesthesia group.However,no serious operation-related adverse events occurred in the two groups,and the small bowel examination was successfully completed.Endoscopic resection was performed in 3 adenoma patients and 1 patient with P-J syndrome in the intravenous anesthesia group.Endoscopic submucosal dissection was performed in 1 case of small intestinal stromal tumor.Argon plasma coagulation was performed in 1 patient with yellow melanoma,with a treatment rate of 6.32%(6/95).Endoscopic resection was performed on 3 adenomas in the awake sedation group.Endoscopic submucosal dissection was performed in 1 case of small intestinal stromal tumor,with a treatment rate of 4.21%(4/95).All the patients treated under the microscope had no serious complications such as massive bleeding,infection and perforation during and after the operation,and recovered well after the operation.Conclusions:Single balloon enteroscopy for patients with unexplained abdominal pain is easier to perform under intravenous anesthesia.Under intravenous anesthesia and awake sedation has a higher detection rate and diagnosis rate,which is of great value in the diagnosis of small intestinal diseases.Besides,Single balloon enteroscopy also has the ability of microscopic treatment,which is safety in both examination and treatment.Therefore,Single balloon enteroscopy is a relatively effective way of diagnosis and treatment.