胶囊内镜在慢性腹痛患者中的应用价值

目的探讨胶囊内镜在慢性腹痛中的诊断价值和安全性。方法对2008年8月至2009年11月期间不明原因的慢性腹痛患者24例进行胶囊内镜检查,同期12例体检者作为对照组。观察两组患者的小肠运转时间、病变及部位、图像质量及顺应性。结果所有受检者在胶囊内镜检查过程中无任何不适和并发症,均顺利完成检查,所得图像清晰。胶囊1～3d自然排出。腹痛组小肠转运时间为（252．69±95．19）min,体检组小肠运转时间为（209．33±34．32）min。其中腹痛组4例胶囊未通过回盲瓣,体检组1例胶囊未通过回盲瓣。检出病变有胃溃疡、小肠炎症、克罗恩病、小肠NSAIDs溃疡、息肉、间质瘤及肠道寄生虫等。结论胶囊内镜检查无痛苦,成功率高,对病变检出率高,对不明原因慢性腹痛患者有较好的诊断价值。     

胶囊内镜在慢性腹痛患者中的临床应用

目的:探讨国产OMOM胶囊内镜在慢性腹痛患者中的临床应用价值。方法:2010年8月至2011年7月间,应用OMOM胶囊内镜(重庆金山科技集团生产)对22例慢性腹痛患者进行检查,明确慢性腹痛的原因。结果:22例慢性腹痛患者经胶囊内镜检查,诊断小肠溃疡2例(9%),小肠息肉2例(9%),小肠黄色瘤2例(9%),小肠狭窄2例(9%),非特异性小肠炎症4例(18%),小肠毛细血管扩张症1例(4.5%),小肠套叠1例(4.5%),回肠克罗恩病1例(4.5%),空肠多发憩室1例(4.5%),其余8例发现慢性浅表性胃炎、胃息肉、十二指肠球炎、结肠炎,2例无明显异常,其中7/22(35%)为症状无关的发现。结论:国产OMOM胶囊内镜对不明原因腹痛患者的诊断有一定意义,而且安全无痛苦,具有较好的临床应用价值。     

胶囊内镜对小肠钩虫病的诊断价值

长期以来,小肠疾病的诊断始终缺乏诊断率较高而无创的检查方法。近年胶囊内镜的应用,提高了小肠疾病的诊断率,无疑是一种无痛、安全的胃肠道检查新方法。2001年以来,我们在150例怀疑小肠疾病(其中有106例怀疑小肠出血)行胶囊内镜检查的患者中发现3例小肠钩虫病,现报告如下。1病例资料【例1】男,66岁,农民。因反复柏油样便伴上腹隐痛不适1月余就诊。发病以来每日排柏油样便1或2次,每次量约100～200g。查体:重度贫血貌,浅表淋巴结不大。腹平软,脐周及上腹轻压痛,未触及包块,肝脾未触及。医技检查:血白细胞4.5×109/L,红细胞1.91×1012/L,血红…     

胶囊内镜对食管疾病的诊断价值

目的：探讨胶囊内镜对食管黏膜的观察能力及对食管疾病的诊断价值。方法：80例行胶囊内镜检查的患者前瞻随机分组为研究组和对照组,每组40例。观察不同体位下胶囊内镜对食管黏膜的观察情况,并与胃镜检查结果进行比较。结果：实验组可获得平均长为599s和1209帧食管图像以供诊断使用,显著高于对照组的9s和18帧（P〈0.01）。胶囊内镜观察结果与胃镜检查结论具有一致性。结论：胶囊内镜对食管黏膜的观察和疾病的诊断是安全可行。     

胶囊内镜和双气囊内镜在不明原因腹痛腹胀患者诊断中的应用

目的评价胶囊内镜和双气囊小肠镜在不明原因腹痛患者诊断中的价值。方法对2007年10月～2009年9月中经胃肠镜及其他检查排除其他系统疾病的不明原因腹痛患者112例进行胶囊内镜及双气囊小肠镜检查。胶囊内镜93例,双气囊内镜24例,其中经口19例,经肛5例。同时接受双气囊内镜及胶囊内镜检查2例。结果诊断结果为小肠间质瘤18例,小肠腺癌4例,小肠海绵状血管瘤2例,炎症性肠病8例,小肠血管畸形5例,小肠淋巴管扩张8例,小肠非特异性炎症23例,小肠寄生虫3例,未见明显异常41例。胶囊内镜检出率为59.1%,双气囊内镜检出率为66.7%。同时接受胶囊内镜及双气囊内镜的检出率为100%。结论胶囊内镜和双气囊内镜对不明原因腹痛患者的诊断价值高,而且是安全可靠的手段。     

磁控胶囊内镜在儿童再发性腹痛中的诊断价值

目的探讨磁控胶囊内镜在儿童再发性腹痛（RAP）中的应用价值。方法回顾性分析2021年1月-2021年6月上海交通大学医学院附属儿童医院内镜中心125例行磁控胶囊内镜检查的RAP患儿的临床资料,分析镜下病变检出情况和胶囊内镜在消化道各部位运行时间等。结果125例患者中,35例拟行全小肠检查（1例因吞服失败而未完成）,90例在磁控条件下行食管及胃部检查。磁控胶囊内镜在食管内的中位运行时间为8.5 (5.3,12.5) s,在胃内的中位运行时间为49.0 (17.7,94.0) min,行全小肠检查的患儿,胶囊内镜在小肠内的中位运行时间为252.0 (192.5,340.0) min,全小肠检查完成率为97.1%(34/35）,检查完成后所有胶囊内镜均顺利排出体外。上消化道病变检出率为71.8%(89/124）,小肠病变检出率为68.6%(24/35）。磁控胶囊内镜对儿童RAP的总体病变检出率为73.4%(91/124）。结论磁控胶囊内镜在RAP患儿胃肠道病变检查中有较高的病变检出率,且安全无痛苦,具有一定的临床应用价值。     

胶囊内镜在基层医院小肠疾病的诊断价值

目的观察胶囊内镜（CE）对小肠疾病的阳性检出率,并评价其对各种小肠疾病的诊断价值。方法收集120例怀疑存在小肠疾病的患者作为观察纽,再另选30例无消化道症状的患者作为对照组。分别对两组进行CE检查,通过图文工作系统进行阅片分析,对其阳性检出率进行评估。结果观察组中,小肠病变的检出率为73．3％（88例）,其中小肠炎症最常见19％（23例）,其次为小肠溃疡15％（18例）,钩虫病12．5％（15例）、血管病变10．8％（13例）、回盲瓣炎4．2％（5例）、小肠憩室3．3％（4例）,脂质沉着、小肠肿瘤、克罗恩病、淋巴管扩张、小肠息肉各2例,对照组中小肠病变的检出率为23．30％（7例）。受检者顺应性良好,2例因胃内滞留由胃镜辅助送入十二指肠,未发生梗阻及嵌顿等并发症,无1例CE滞留体内。结论CE能提高小肠疾病的阳性检出率,使病因未明的消化道疾病患者能及时获得治疗,因此在小肠疾病的诊治中具有重要诊断价值。     

胶囊内镜在小肠出血性疾病诊断中的应用

对于上消化道出血或肛门、直肠、结肠病变出血，多可行胃镜、十二指肠镜、纤维结肠镜检查，诊断较方便准确。而对于小肠出血性疾病，常用内镜难以到达，其他常见诊断方法确诊率较低，诊断较困难。胶囊内镜的问世，大大改变了这一状况。     

胶囊内镜检查对小肠疾病的诊断价值

目的:分析胶囊内镜在消化道疾病中的应用,探讨可能影响其检查结果的因素。方法:疑有消化道疾病但经胃镜、肠镜和腹部超声后均不能明确诊断的患者37例,按年龄分为2组,其中≥70岁为高龄组(20例)。对37例患者进行胶囊内镜检查,并对可能影响胶囊内镜检查的因素如年龄、性别、腹部手术史、糖尿病史、是否服用非甾体类消炎药等做多因素回归分析。结果:37例患者经胶囊内镜检查后,明确诊断16例(43.2%);可疑诊断13例(35.1%);阴性病例8例(21.6%)。总检出率为78.4%。胶囊内镜检出小肠克隆氏病1例,小肠腺癌1例,出血性空肠炎1例,升结肠癌1例,血管显露、血管发育不良26例,小肠炎症10例,小肠息肉11例。本研究中,高龄患者的食管内时间、胃内时间和小肠内时间较长,但2组差异无统计学意义;37例均无胶囊滞留体内,但有1例食管滞留和1例胃内滞留,且均发生在高龄组;1例褐色肠液多影响观察,1例图像存在干扰影响观察。本研究有5例胶囊未进入结肠,视为未完成小肠检查,均发生在高龄患者中,2组差异具有统计学意义(t=-2.315,P=0.027),说明年龄对于小肠的检查有影响。多因素回归分析显示,腹部手术史、糖尿病史、服用非甾体类消炎药药物史等2组差异均无统计学意义。结论:对于怀疑小肠疾患而无检查禁忌的高龄患者,胶囊内镜可作为首选检查,因其具有安全、无痛苦、顺应性好等优点而易于被患者接受。但高龄患者的胃肠道活动减弱,食管和胃内滞留率增高,小肠通过时间延长,所以在胶囊内镜的检查过程中应加强监测,可予增加胃肠蠕动的药物。     

OMOM胶囊内镜在小肠出血性疾病诊断中的应用

目的总结国产OMOM胶囊内镜在小肠出血性疾病诊断中的应用。方法 38例疑有出血性小肠疾病的患者,检查前均行胃、肠镜检查,排除上、下消化道疾病,部分患者行消化道钡餐检查,采用重庆金山科技公司OMOM胶囊内镜系统进行检查并进行回顾性总结分析。结果所有胶囊均排出体外,2例患者胶囊在胃内滞留2小时后通过胃镜送入小肠,检查成功率为100%。胶囊在小肠运行时间86～507分钟,平均296分钟。共发现小肠病变31例,未见异常7例,阳性率81.5%。结论 OMOM胶囊内镜检查安全、可靠、方便,可作为小肠出血性疾病的首选检查方法,对不明原因的消化道出血具有较高的临床意义。     

OMOM胶囊内镜对不明原因腹痛的诊断作用

目的 了解国产OMOM胶囊内镜在慢性腹痛中对小肠疾病的临床诊断应用价值.方法 2008年2月至2010年1月间,应用OMOM胶囊内镜(重庆金山科技集团生产)对67例慢性腹痛患者(腹痛组)和46例无任何症状的查体者(查体组)进行检查,其中腹痛组患者均过经多次胃镜和结肠镜检查,未发现可以解释慢性腹痛的病变.结果 慢性腹痛组患者中小肠黏膜病变的诊断阳性率为68.7%(46/67),明显高于健康查体人群的21.7%(10/46);腹痛组46例小肠黏膜病变中以小肠黏膜非特异性炎症为最多,占21例,其次为小肠单发或者多发的息肉12例;回肠和空肠单发或多发的小溃疡11例,结合临床病史诊断为小肠克罗恩病;小肠肿瘤6例;小肠未发现任何异常的占25.7%(17/67),小肠淋巴组织增生11例.腹痛组患者OMOM胶囊在小肠的通过时间(243.9±61.9)min明显长于查体组(215.3±52.9)min(P＜0.05);胶囊探头的胃通过时间(42.6±18.9)min和排出体外的时间(83.9±27.4)h,分别比查体组(40.6±13.4)min和(74.3±19.1)h要长,但是差异均无统计学意义(P＞0.05).结论 国产OMOM胶囊内镜对小肠黏膜病变的诊断阳性率高,而且安全无痛苦,具有较好的临床应用价值,尤其适用于不明原因的慢性腹痛患者.     

HLA-B27 as a diagnostic screening tool in chronic low back pain

Forty-five of 52 consecutive patients with chronic low back pain were screened for presence of HLA-B27 antigen one year after they were included in a rehabilitative program. Six (13.3%) were positive and, when re-examined radiographically, 2 had signs of ankylosing spondylitis. The proportion of antigen-positive individuals is similar to that found in a population study of healthy Swedish blood donors, and within the range of other populations of healthy controls. It is concluded that HLA-B27 is of limited diagnostic value as a screening test for ankylosing spondylitis in a patient group with chronic low back pain.     

Video wireless capsule endoscopy: a diagnostic tool for early Crohn's disease.

Crohn's disease is a chronic immune-mediated disease that affects any or all segments of the gastrointestinal tract, but is mainly found in the small intestines or colon. Crohn's disease in the early stages present with symptoms such as chronic diarrhea, abdominal pain, and weight loss that may mimic other conditions and cause a delay in diagnosis. Many patients experience emotional difficulties related to this debilitating disease. Current procedures used to visualize the small bowel for diagnosis of Crohn's disease include small-bowel follow through, enteroclysis, and computerized tomography, but do not provide definition of the mucosal surface. Clinical research shows us the diagnostic yield of these tests are not as high as once thought. A new diagnostic tool, the M2A Video Capsule, can be used to visualize the small bowel mucosa. With the detailed photo images provided by the capsule, the physician now has the ability to detect subtle changes in the mucosal lining that may be consistent with early Crohn's disease that were previously not available or identifiable. Earlier disease treatment and management may decrease the inflammatory changes that lead to bowel thickening and stricturing and have a positive impact on the patient's total quality of life.     

The yield of capsule endoscopy in patients with abdominal pain or diarrhea

BACKGROUND AND STUDY AIMS: Capsule endoscopy, proven effective for evaluation of obscure gastrointestinal bleeding and suspected Crohn's disease, is increasingly used to investigate other small-intestine disorders, but its yield for other indications is not well known. We sought to evaluate its yield and findings for abdominal pain or diarrhea. PATIENTS AND METHODS: Medical records of patients with abdominal pain or diarrhea (> 6 weeks' duration) who underwent capsule endoscopy between August 2001 and June 2004 were retrospectively reviewed for demographic data, indications, findings, diagnoses, complications, and radiologic studies. All patients had previous endoscopic or radiologic examinations (colonoscopy, enteroscopy, upper endoscopy, small-bowel series, computed tomography enterography, or computed tomography) demonstrating no abnormalities sufficient for diagnosis. RESULTS: 64 patients (26 men; 38 women; mean age, 43 years; age range, 19 - 83 years) who met study criteria had 68 capsule endoscopy studies. Indications were abdominal pain (35 patients), diarrhea (14), or both (15). Complete small-bowel visualization with identification of the cecum was achieved in 81 %; yield of positive findings was 9 % (6 patients). By indications, the yield was 6 % for abdominal pain, 14 % for diarrhea, and 13 % for both. Diagnoses included Crohn's disease (3), enteropathy induced by nonsteroidal anti-inflammatory drugs (2), and submucosal tumor (1). Capsule retention occurred in two patients, requiring surgical removal. CONCLUSIONS: Capsule endoscopy had a low yield for evaluation of abdominal pain or diarrhea and cannot be recommended as a first-line test without further study. Nonetheless, it facilitated diagnosis in 9 % of patients with negative endoscopic and radiologic examinations.     

Leptin as a new diagnostic tool in chronic heart failure

Leptin, the product of the ob-gene, regulates cellular homeostasis and glycemic control. While initially described as an adipocyte-derived protein with expression and secretion restricted to adipose tissue, recent reports have shown local expression of leptin in several tissues including the skeletal muscle, heart, vessels and brain. Leptin acts through the different isoforms of its receptor which are ubiquitously expressed and can be detected in endothelium, vascular smooth muscle and myocardium. In addition to its metabolic effects, leptin has distinct effects in the cardiovascular system leading to increased production of proinflammatory cytokines and oxidative stress, vascular remodeling and neointima formation as well as cardiomyocyte hypertrophy. Notably, recent clinical studies have linked serum levels of leptin to the occurrence of cardiovascular events such as myocardial infarction and stroke suggesting that leptin promotes pro-atherogenic vascular mechanisms. In contrast, less is known about the role and effects of leptin in the setting of chronic heart failure. We here review the current knowledge on cardiovascular effects of leptin and discuss its potential as a new therapeutic tool in chronic heart failure.     

Capsule endoscopy for the evaluation of patients with chronic abdominal pain

BACKGROUND AND STUDY AIMS: Chronic abdominal pain is a common complaint and in many patients even an extensive work-up does not reveal the cause for the pain. Given Imaging wireless capsule endoscopy is a new method for visualization of the entire small bowel. The aim of our study was to determine the role of capsule endoscopy in the evaluation of patients with unexplained chronic abdominal pain. PATIENTS AND METHODS: 20 patients with chronic abdominal pain of 6 - 96 months' duration were enrolled in the study. They had had an extensive diagnostic work-up which was negative. Capsule endoscopy was performed in all patients. RESULTS: Imaging of the small intestine was excellent and the colon was reached in 16 patients. In 14 patients the study was completely normal; in six patients the procedure revealed findings which were considered to be clinically insignificant. All patients tolerated the capsule well and had no adverse effects. CONCLUSION: Capsule endoscopy did not seem to have any significant clinical value in the evaluation of our patients with obscure chronic abdominal pain.