胶囊内镜诊断不明原因消化道出血的临床研究

目的探讨胶囊内镜用于不明原因消化道出血的临床价值。方法选取2011年4月至2013年4月佛山市第五人民医院收治的不明原因消化道出血患者297例,给予Given公司生产的无线胶囊内镜吞服,以吞服后8 h为检查时间。观察胶囊内镜通过消化道的时间、胶囊回收率、不同性质出血患者检出阳性率及检出阳性患者的临床指标并进行比较。结果胶囊在消化道通过时间胃内约为25 min,小肠约为270 min。共有204例(68.69%)患者在结束检查时内镜顺利通过回盲瓣到达结肠,另外93例(31.31%)患者在检查过程中未完全通过小肠。显性出血患者胶囊内镜检查的阳性率为86.93%,与隐性出血患者的胶囊内镜检查阳性率(78.57%)比较差异无统计学意义(P>0.05)。年龄≥50岁者小肠动静脉畸形检出率显著高于年龄<50岁者(P<0.05),而且女性小肠动静脉畸形检出率显著多于男性(P<0.05),年龄≥50岁者肠克罗恩病检出率显著高于年龄<50岁者(P<0.05)。结论使用胶囊内镜对不明原因消化道出血进行诊断,具有较高的确诊率,而且无创伤,安全性高,具有极高的临床应用价值。

Capsule Endoscopic Diagnosis of Obscure Gastrointestinal Hemorrhage

Objective To investigate the clinical value of capsule endoscopy for obscure gastrointestinal bleeding. Methods During Apr. 2011-Apr. 2013 from Foshan City Fifth People＇s Hospital,297 cases of unexplained gastrointestinal bleeding 297 cases were given Given company＇s wireless capsule endoscopy swallow, and 8 h after ingestion was inspection time. The capsule endoscopy going through the digestive tract time, capsule recovery rate, the positive rates of different natures bleeding and the clinical indicators of the positive cases were observed and compared. Results The capsule stay time in the stomachwas approximately 25 rain, in the small intestine was approximately 270 min. Altogether 204 cases （68.69 % ） with the capsule going to the ileocecal valve smoothly through the colon at the end of the examination, the other 93 cases （ 31.31% ） did not completelygo through the small intestine at the end of the check. Positive results rate was 86.93% in patients with overt bleeding while it was 78.5＂7% in patients with occult bleeding,the difference was not statistically significant（ P 〉 0.05 ）. Intestinal arteriovenous malformation in patients ~〉 50 years was significantly higher than in patients 〈 50 years（ P 〈 0.05 ）. And female patients with intestinal arteriovenous malformation were significantly more than male （ P 〈 0.05 ）. Intestinal Crohn＇ s disease detection rate of patients t〉50 years was significantly higher than the age 〈 50 years （ P 〈 0.05 ）. Conclusion The use of capsule endoscopy in obscure gastrointestinal bleeding diagnosis, has a high rate of diagnosis with the features of non-invasiveness and high safety,which has a high clinical value.