OMOM胶囊内镜诊断不明原因消化道出血的临床研究

目的 研究OMOM胶囊内镜诊断不明原因消化道出血(OGIB)的临床效果.方法 选取三门峡市中心医院2016年3月～2020年4月期间接收的OGIB患者64例作为研究对象,予以OMOM胶囊内镜检查以CT小肠成像(CTE),以单气囊小肠镜或双气囊小肠镜检查结果作为金标准,分析OMOM胶囊内镜的诊断价值.结果 经单气囊或双气...     

胶囊内镜对不明原因消化道出血诊断价值的研究

目的：评价胶囊内镜在不明原因消化道出血（OGIB）诊断中的价值。方法：回顾性分析2007年6月-2011年1月隐性或显性OGIB患者的资料,对经常规上、下消化道内镜检查均无异常发现的患者行胶囊内镜检查,并对其临床相关资料进行统计学分析。结果：82例OGIB患者（男55例,女27例）,年龄（43±15）岁,其中71例表现为显性消化道出血,11例为隐性消化道出血。胶囊内镜检查发现可解释出血原因的病变共66例（80％）（58例显性出血,8例隐血）;最常见的病变为血管动静脉畸形（30％）和克罗恩病（26％）。所有患者均未出现肠梗阻症状。结论：胶囊内镜检查对OGIB患者具有较高的诊断价值。     

胶囊内镜对不明原因消化道出血最佳检查时机的研究

目的：探讨胶囊内镜（capsule endoscopy,CE）检查不明原因消化道出血的时机。方法：选择我院2002年5月至2005年1月91例不明原因消化道出血患者,共行94次CE检查。根据其检查时出血情况不同,分成2组,A组为活动性出血组（41例,包括显性出血37例和持续隐性出血4例）,B组为出血停止组（50例）。结果：CE检查的阳性率为74.7%（n=68）,疑诊率为11.0%（n=10）,检出率85.7%,阴性率为14.3%（n=13）。活动性出血组的CE检出率明显高于出血停止组（95.1%比78%,P=0.032）,但显性出血者与隐性出血者间检出率的差异无统计学意义（97.3%比75.0%,P=0.188）;出血停止组中,2周内刚停止出血者（29例）的检出率亦明显高于出血停止2周以上（21例）者（93.1%比57.1%,P=0.004）,但活动性出血时与出血停止2周内的检出率差异则无统计学意义（95.1%比93.1%,P〉0.05）。结论：对不明原因消化道出血,CE最佳检查时机为少量活动性出血时和出血停止2周内,该时段检出率高。     

胶囊内镜检查对110例不明原因 消化道出血的诊断分析

目的探讨胶囊内镜对不明原因消化道出血的诊断价值,并观察患者使用胶囊内镜的顺应性和安全性。方法对2008年8月~2012年8月110例不明原因消化道出血患者的胶囊内镜检查结果进行回顾性分析,评价其疾病诊断率和安全性。结果 110例患者均顺利完成检查。共检出小肠病变97例,检出率88.2%。其病因包括:小肠血管畸形71例,小肠非特异性炎症25例,间质瘤4例,克罗恩病5例,蛔虫症7例,息肉3例,憩室3例,淋巴瘤1例。受检者顺应性良好,未发生梗阻及嵌顿等并发症。结论患者对胶囊内镜耐受性好,胶囊内镜是小肠出血的安全、有效、舒适的检查手段,在不明原因消化道出血诊断中有着特殊优势。     

胶囊内镜在不明原因严重的消化道出血中的诊断作用

目的探讨胶囊内镜(CE)在不明原因严重的消化道出血(OGIB)中的诊断作用。方法回顾性分析该院胶囊内镜检查的12例不明原因严重的消化道出血患者的临床资料。结果 12例患者均顺利完成检查,平均通过小肠时间为261min,其中2例(13.3%)未通过回盲瓣。共检出小肠病变10例,胶囊内镜的阳性率为83%。病因包括:毛细血管扩张2例(13.3%),毛细血管瘤1例(6.7%),动静脉畸形1例(6.7%),小肠多发溃疡2例(13.3%),小肠淋巴管扩张并出血1例(6.7%),小肠肿瘤3例(25%)。结论胶囊内镜检查耐受性好,安全、有效,诊断不明原因的严重消化道出血价值高。OGIB以小肠血管损伤最常见,其次为小肠肿瘤。     

不明原因消化道出血患者行胶囊内镜检查的护理

目的探讨应用胶囊内镜对不明原因消化道出血患者检查的护理方法。方法回顾性分析2010年10月至2013年10月在海军第411医院消化内科治疗的25例不明原因消化道出血患者的临床资料,所有患者均行胶囊内镜检查,总结胶囊内镜检查前、检查中护理配合方法以及检查后护理观察要点。结果 25例患者均顺利完成胶囊内镜检查,内镜图片清晰,检查过程中患者无特殊不适。结论胶囊内镜检查安全、无创、简便,良好的护理配合有助于患者顺利完成检查,获得清晰的图像,提高病变检出率。     

不明原因消化道出血病人胶囊内镜检查的护理

[目的]总结不明原因消化道出血病人胶囊内镜（CE）检查的护理。[方法]对163例不明原因消化道出血病人进行胶囊内镜检查,同时加强检查前、中、后的观察和护理。[结果]成功完成检查161例,失败2例,其中检出病变89例,病变检出率为55.3%;检查过程中病人无任何不适,图像清晰,取得满意效果。[结论]胶囊内镜检查病人的护理,尤其是检查前病人良好的肠道准备是胶囊内镜检查成功的重要环节,并且能够提高胶囊内镜检查病人病变的检出率,检查中的密切配合对检查成功起着重要的作用。     

胶囊内镜在不明原因消化道出血病因诊断中的应用

目的 评价胶囊内镜对不明原因消化道出血的诊断价值.方法 对26例不明原因消化道出血患者行胶囊内镜检查的结果.结果 肠道血管畸形11例,十二指肠腺癌1例,回肠脂肪瘤1例,小肠克罗恩病3例,小肠息肉3例,十二指肠憩室炎1例,多发性小肠溃疡3例,阴性3例,病变检出率为88.5%(23/26例).部分病例经手术病理证实.结论 胶囊内镜检查安全、无创,对不明原因消化道出血具有较高的诊断价值.     

胶囊内镜对不明原因消化道出血患者临床诊断价值

不明原因消化道出血（OGIB）系指经过食管-胃-十二指肠镜检查、结肠镜检查、小肠放射学检查如小肠钡餐造影或小肠钡灌肠检查,无明确病因的持续或者反复胃肠道出血。其发病率在消化道出血中约占5％。0GIB的出血部位多位于小肠,常规内镜和传统检查方法对其诊断价值有限。胶囊内镜的出现开创了全小肠直视性检查的先河。且患者毫无痛苦,从而对小肠病变的诊断有了很大的提高。本院在2004年5月-2008年10月间对32例不明原因消化道出血患者进行了胶囊内镜检查,现总结如下。     

双气囊内镜对不明原因消化道出血病因的诊断价值

目的探讨双气囊内镜(DBE)在不明原因消化道出血(OGIB)病因诊断中的临床应用价值。方法对31例解黑便或血便且经过多次胃镜、肠镜检查不能确定出血病灶等怀疑为小肠出血者患进行双气囊内镜检查,分析其病因诊断率及其安全性。结果 31例行双气囊内镜检查,经口检查20例,经肛检查5例,经口+经肛6例,发现病灶25例,未发现病灶6例,病因诊断率80.6%(25/31)。未见操作相关严重不良反应和并发症。结论双气囊内镜检查安全、可靠,对不明原因消化道出血病因诊断率显著提高,是一种有效的检查手段。     

Use of anticoagulation during wireless capsule endoscopy for the investigation of recurrent obscure gastrointestinal bleeding

Detecting the source of obscure gastrointestinal bleeding can be difficult. Capsule endoscopy is a promising diagnostic tool for investigating patients with this condition, although identifying the source of intermittent or low-grade bleeding remains a diagnostic challenge. We present case reports of two patients with obscure gastrointestinal bleeding, in whom the source of recurrent bleeding episodes was diagnosed by capsule endoscopy while they were on anticoagulation therapy. The first patient, an 81-year-old white woman, was on long-term oral anticoagulation because she had chronic atrial fibrillation. Capsule endoscopy demonstrated a bleeding tumor in the region of the terminal ileum. The second patient, a 59-year-old white man, underwent an initial capsule endoscopy, which was negative. After initiation of anticoagulation with heparin, a second capsule endoscopy procedure in this patient revealed several small bleeding lesions in the proximal small bowel. In both cases a gastrointestinal stromal tumor was identified as the bleeding source and was resected. These two cases demonstrate that provocation of bleeding during capsule endoscopy may increase its sensitivity.     

Video capsule endoscopy for investigation of obscure gastrointestinal bleeding: feasibility, results, and interobserver agreement

BACKGROUND AND STUDY AIMS: The aim of the study was to assess the feasibility, diagnostic yield, and interobserver agreement of capsule endoscopy in the investigation of patients with obscure or occult gastrointestinal bleeding. PATIENTS AND METHODS: A total of 64 consecutive patients with occult bleeding (31 %) or overt bleeding (69 %) were assessed using capsule endoscopy after negative upper and lower endoscopy and small-bowel radiology. The quality of visualization of the small-bowel mucosa was scored from 1 (poor) to 4 (excellent). Thirty video capsule recordings with normal or abnormal findings were blindly assessed by four independent endoscopists. Interobserver agreement was evaluated using the kappa index. RESULTS: The small bowel was completely visualized in 57/64 patients (89 %). Incomplete small-bowel transit was most commonly due to prolonged gastric retention (five patients). The mucosa visualization scores (means) for the proximal, middle, and distal thirds of the small bowel were 3.7, 3.3, and 2.2 respectively. Visualization of the distal ileum was good (> or = 3) in 38 % and a bleeding site was found in 45 % of patients. Push-enteroscopy was also performed in 56 patients. The results of the two techniques were similar in 37 patients, capsule endoscopy was superior in 12 patients, and push-enteroscopy was superior in seven patients. Interobserver agreement was good for bleeding and for angiodysplasia, but poor for ulcers and tumors. Mean interobserver agreement was better among experienced endoscopists than among junior endoscopists. CONCLUSIONS: Capsule endoscopy allowed the whole small intestine to be explored in 89 % of patients, with good visualization of the mucosa, except distally. Interobserver agreement was better among the experienced endoscopists and was better for red-colored abnormalities (bleeding and angiodysplasia) than for ulcers and tumors.     

Wireless capsule endoscopy in a patient with obscure occult bleeding

A case of obscure/occult bleeding in a 39-year old man with a 7-year history of chronic fatigue and iron-deficiency anemia is presented here. Esophagogastroduodenoscopy, push enteroscopy, ileocolonoscopies, and a magnetic resonance imaging small-bowel follow-through did not reveal any abnormalities. Multiple inflammatory lesions with fibrin-covered ulcers and petechial bleeding in the area of the lower jejunum and ileum were diagnosed only with capsule endoscopy. One ulcer located near the ileocecal valve was then biopsied during a repeat ileocolonoscopy, and the histology showed signs of Crohn's enteritis. The further treatment approach was changed, with medical treatment being initiated and intraoperative enteroscopy being averted. Wireless capsule endoscopy clarified the cause of the obscure/occult bleeding in this patient and contributed to the diagnosis and endoscopic imaging of an isolated Crohn's enteritis, which is the cause of bleeding in approximately 10 - 20 % of cases of occult bleeding.     

磁控胶囊内镜在不明原因消化道出血诊治中的应用及临床观察

目的 探讨磁控胶囊内镜（MCCE）在不明原因消化道出血（OGIB）诊治中的应用及临床观察。方法 回顾性分析2021年6月－2022年6月该院40例运用MCCE治疗OGIB患者的临床资料,以探讨MCCE的应用特点及优势。结果 40例患者均顺利完成胃及小肠的MCCE检查,人工阅片与辅助阅片系统一致的32例（80.00%,32/40）,确诊病例为15例（37.50%,15/40）,与辅助阅片系统诊断相符病例11例（73.33%,11/15）。15例患者中,有10例拟诊为小肠疾病,3例为结肠疾病,2例为上消化道疾病;5例行外科手术治疗,2例行内镜下止血治疗,5例口服药物治疗,3例随诊观察。结论 MCCE在OGIB的病例诊断中,具有兼顾对胃腔巡航式检查的优势。与传统的胶囊内镜比较,其为小肠系统和结肠疾病的内镜诊断,提供了重要的参考信息和诊断价值。     

胶囊内镜和结肠镜同步检查诊断不明原因消化道出血

目的 探讨胶囊内镜(CE)和结肠镜同步检查在不明原因消化道出血(OGIB)诊断中的意义.方法 对100例不明原因消化道出血患者进行胶囊内镜和结肠镜同步检查.结果 100例患者中98例完成胶囊内镜和结肠镜的肠道内对接检查,检出病变98例,其中肿瘤性病变41例(41.8％),非肿瘤性病变57例(58.2％).36例依据联合同步检查的结果,经腹腔镜、结肠镜和(或)手术切除病灶,得到根治;其中回盲部腺癌4例(4％).结论 胶囊内镜在不明原因消化道出血患者中的同步结肠镜检查在病因诊断中有较高的价值,且可大大提高回盲部腺癌的确诊率.