单气囊小肠镜在Peutz-Jeghers综合征患儿长期随访中的应用及效果评价

doi:10.12372/jcp.2025.24e1133

摘要/Abstract

摘要：

目的探讨单气囊小肠镜（SBE）在Peutz-Jeghers综合征（PJS）患儿小肠息肉长期随访中的应用价值和效果。方法回顾性分析新华医院消化科2011年1月至2024年6月收治的10例接受SBE长期随访的PJS患儿的临床资料。结果 10例PJS患儿中男7例、女3例，确诊PJS时的中位年龄为9.5（6~16）岁，中位随访时长为132（95~137）个月，随访间隔中位时间17.3个月。共进行46次SBE检查，其中29例次经口进镜，17例次经肛门进镜，治疗息肉157枚。每例患儿治疗直径>15 mm息肉的中位数目为7（1~13）枚。经SBE随访治疗后患儿腹部症状及贫血均有明显改善。随访期间仅1例患儿因肠套叠需要手术治疗，可能与随访间隔太长及随访不规律有关。经口小肠镜患儿术后均有咽痛（100%）；SBE术后腹胀8例次（17.4%）；穿孔1例次（2.2%），经内科保守治疗后好转。结论应用SBE对PJS患儿进行长期规律随访及预防性小肠息肉切除是一种安全有效的方法，对于改善腹部症状、降低肠套叠及外科手术风险具有重要意义。

关键词: Peutz-Jeghers综合征, 小肠镜, 小肠息肉, 肠套叠, 儿童

Abstract:

Objective To investigate the application value and effect of single balloon enteroscopy (SBE) in long-term follow-up of small intestinal polyps in patients with Peutz-Jeghers syndrome (PJS). Methods The clinical data of 10 patients with PJS who were admitted to the Gastroenterology Department of Xinhua Hospital from January 2011 to June 2024 and received long-term follow-up with SBE were retrospectively analyzed. Results Among the 10 children with PJS, there were 7 boys and 3 girls. The median age at diagnosis of PJS was 9.5 (6-16) years. The median follow-up time was 132 (95-137) months, and the median follow-up interval was 17.3 months. A total of 46 SBE examinations were performed (29 via mouth and 17 via anus), and 157 polyps were treated. The median number of polyps >15 mm in diameter treated in each patient was 7 (1-13). After SBE follow-up treatment, the abdominal symptoms and anemia of the patients were significantly improved. During the follow-up period, only 1 patient needed surgery due to intussusception, which may be related to the long follow-up interval and irregular follow-up. Postoperative sore throat was found in all patients with transoral enteroscopy (100%). Abdominal distension after SBE was observed in 8 cases (17.4%). Perforation occurred in 1 case (2.2%) and improved after conservative medical treatment. Conclusions Long-term regular follow-up and preventive resection of small intestinal polyps with SBE in PJS patients is a safe and effective method, which is of great significance for improving abdominal symptoms and reducing the risk of intussusception and surgery.

Key words: Peutz-Jeghers syndrome, enteroscopy, polyp of small intestine, intussusception, child

蔡美洪, 徐雷鸣, 瞿春莹, 李郑红, 沈峰, 李鸣鸣, 张毅. 单气囊小肠镜在Peutz-Jeghers综合征患儿长期随访中的应用及效果评价[J]. 临床儿科杂志, 2025, 43(5): 340-344.

CAI Meihong, XU Leiming, QU Chunying, LI Zhenghong, SHEN Feng, LI Mingming, ZHANG Yi. Application and effect evaluation of single balloon enteroscopy in long-term follow-up of patients with Peutz-Jeghers syndrome[J]. Journal of Clinical Pediatrics, 2025, 43(5): 340-344.

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随访次序	患儿例数	治疗息肉数目/枚	治疗直径>15mm息肉数/枚	治疗最大息肉直径/mm
1	10	4(0~6)	0(0~3)	11(0~50)
2	9	4(1~10)	1(0~6)	30(8~40)
3	6	4(1~10)	3(0~4)	22.5(10~60)
4	6	2(1~6)	1(0~3)	27.5(12~45)
5	4	3(0~4)	3(0~3)	23(0~40)
6	3	2(1~6)	2(1~6)	22(20~45)
7	3	2(0~3)	1(0~2)	15(0~30)
8	3	4(1~9)	3(1~9)	25(25~50)
9	1	3	3	30
10	1	6	5	25