187例OMOM胶囊内镜回顾性分析

目的探讨胶囊内镜(CE)对小肠疾病的诊断价值及未完成全小肠检查(UCSE)的危险因素。方法收集2016年5月至2019年5月于武汉大学人民医院连续进行OMOM胶囊内镜检查的187例患者的相关临床资料,回顾性分析CE小肠病变检出和诊断情况、全小肠检查完成情况及UCSE的可能危险因素。结果CE小肠病变检出率为64.2%(120/187),小肠病变诊断率为35.8%(67/187),CE对消化道出血患者的小肠病变检出率和诊断率均明显高于腹痛、腹泻患者(P<0.05);CE小肠检查完成率89.3%(167/187)。单因素分析表明糖尿病、住院、小肠糜烂/溃疡、胃转运时间(GTT)、小肠转运时间(SBTT)对UCSE有影响(P<0.05);二元Logistic回归分析表明延长的GTT、SBTT是UCSE的独立危险因素。对187例患者进行分析,胆汁反流、检查前服用山莨菪碱患者GTT显著延长(P<0.05),对167例完成全小肠检查患者进行分析,年龄≥55岁、住院患者SBTT显著延长(P<0.05);GTT超过2 h患者UCSE的可能性是GTT≤30 min患者的8.667倍(95%CI:2.350~31.962,P=0.001)。结论胶囊内镜对小肠疾病特别是消化道出血有很好的诊断价值,但检查前不应服用山莨菪碱等可能引起患者胃轻瘫的药物,对胆汁反流、≥55岁、住院的患者应进行实时监控,当发现胶囊在胃或小肠内运输缓慢时采取适当干预方式,争取让CE 2h内进入十二指肠,提高胶囊内镜小肠检查完成率。

Retrospective analysis of 187 cases of OMOM capsule endoscopy

Objective To explore the diagnostic value of capsule endoscopy(CE)for small bowel diseases and the risk factors of unfinished complete small-bowel examination(UCSE).Methods Collect relevant clinical data of 187 patients with 0 M0 M capsule endoscopy performed continuously from May 2016 to May 2019 in Renmin Hospital of Wuhan University and retrospectively analyze the detection and diagnosis of CE small bowel lesions,the completion of the whole small bowel examination,and the possible risk factors of UCSE.Results The detection rate of CE small bowel lesions was 64.2%(120/187),and the diagnosis rate of small bowel lesions was 35.8%(67/187).The detection rate and diagnosis rate of CE for patients with gastrointestinal bleeding were significantly higher than that of patients with abdominal pain,diarrhea(P<0.05).CE small bowel examination completion rate was 89.3%(167/187),univariate analysis showed that diabetes,hospitalization,small bowel erosion/ulcer,gastric transit time(GTT),small bowel transit time(SBTT)have an impact on UCSE(P<0.05),binary Logistic regression analysis showed that prolonged GTT and SBTT are risk factors for UCSE;Analysis of 187 patients showed that GTT was significantly prolonged in patients with bile reflux and taking anisodamine before examination(P<0.05),and 167 patients who completed small-bowel examination were analyzed,SBTT was significantly prolonged in patients with aged≥55 years and hospitalized(P<0.05).The probability of UCSE in patients with GTT exceeding 2 hours is 8.667 times that of patients with GTT≤30 min(95%CI:2.350-31.962,P=0.001).Conclusion CE has a good diagnostic value for small intestinal diseases,especially gastrointestinal bleeding.However,anisodamine and other drugs that may cause gastroparesis should not be taken before examination.Patients with bile reflux,≥55 years old,hospitalized should be monitored in real time.When the CE is found to be transported slowly in the stomach or the small intestine,appropriate intervention methods should be adopted and the CE should enter the duodenum within 2 hours to increase CE small bowel examination Completion rate.