胶囊内镜常见临床不良事件及预防研究北大核心CSCD

胶囊内镜(capsule endoscopy,CE)在20年的发展中因其能够无创检查消化道而在全球得以广泛运用。但在临床应用中CE仍有不良事件的发生,包括CE滞留、检查不全、吞咽困难及误吸,值得我们高度重视。CE滞留因其存在肠梗阻、肠穿孔的风险而备受关注,克罗恩病是CE滞留最主要的原因,可通过探路胶囊评估滞留高危患者肠道的通畅性而避免CE滞留的发生。食管检查不全可通过提升CE拍摄频率和系线牵拉对抗重力提高检查完成率;胃腔检查通过磁场操控CE运动以及提升胃清洁度,提高胃检查完成率;小肠和结肠检查不全是由于电池续航时间有限,可通过延长续航时间及减少胃通过时间等方式促进检查的完成。小儿吞咽困难发生率较高,需要内镜辅助递送CE至胃十二指肠中。CE误吸极为罕见,多见于高龄患者,绝大多数可通过咳嗽自行排出。充分掌握CE不良事件的危险因素及规避措施对于推广CE的临床应用具有极高的价值。

Common clinical adverse events of capsule endoscopy and related precautions

Capsule endoscopy(CE)has established itself as a noninvasive diagnostic tool for diagnosing gastrointestinal diseases and has been widely used around the world over the past two decades.However,some adverse events,including retention,incomplete examination,swallow disorder and aspiration,can happen in clinical practices and deserve consideration.CE retention is the most noticed adverse event that may lead to intestinal obstruction and perforation,Crohn’s disease is the main reason for retention and patency capsule could predict small bowel strictures in high-retention risk patients to prevent CE retention.Increased frame rate and stringed CE to overcome gravity effect can be used to improve esophageal complete examination rate.Gastric mucosa can be fully examined by magnetic-control and gastric preparation.The incomplete examination of small intestine and colon are mainly caused by limited battery life of CE,and prolonged battery life span and reduced gastric transmit time can promote completion of examination.Young age is associated with higher rate of swallow disorder,and placement devices are needed to deliver CE to duodenum.CE aspiration is very rare,aging patients are at high risk for CE aspiration,and the problem can be solved by coughing spontaneously.It will benefit clinical application of CE to fully master the risk factors of CE adverse events as well as preventive measures.