胶囊内镜在小肠疾病诊断中的作用

目的:小肠疾病很难诊断,现有的诊断技术又不尽如人意,而胶囊内镜能发现整个小肠内的微小病变。为此,我们对胶囊内镜在小肠疾病诊断中的价值进行评估。方法:自2002年5月至2003年9月,我们对经结肠镜、胃镜、X线钡餐造影、小肠钡灌造影、血管造影或核素扫描等检查未发现异常的79例疑患小肠疾病、尤其是不明原因消化道出血的患者,进行胶囊内镜检查,其中不明原因的消化道出血患者56例。结果:75例完成最终研究。75例患者中经胶囊内镜检查共发现异常63例,检出率为84％;其中能明确解释临床病因者50例,诊断率为66.6％,包括消化道血管病变21例、小肠炎症性肠病16例、小肠息肉5例、小肠恶性间质肿瘤2例、小肠类癌1例(该患者同时伴升结肠脂肪瘤)、淋巴瘤1例、粘膜下肿瘤3例及憩室1例。所获取的图像质量良好。结论:胶囊内镜对小肠疾病尤其是不明原因消化道出血具有良好的诊断价值。

The evaluation of capsule endoscopy in patients with suspected small bowel diseases XIAO Shudong, GE

Objective:The diagnosis of small bowel disorders is very difficult. Available techniques to identify small bowel lesions are unsatisfactory. Video capsule endoscopy (M2A) is an innovative technique that can detect very small mucosal lesions in the entire small bowel. This study was to explore the diagnostic value of wireless capsule endoscopy in the diagnosis of small bowel diseases. Methods: From May 2002 to September 2003, we examined 79 patients with suspected small bowel diseases, in particular the gastrointestinal bleeding of unknown origin, and prior normal results on gastroscopy, colonoscopy, small bowel barium radiography, scintigraphy or angiography. Of the 79 patients, 56 complained with obscure recurrent gastrointestinal bleeding. Results:75 patients completed the procedure uneventfully. M2A capsule endoscopy disclosed abnormal small bowel findings in 63 out of 75 patients (84%). 50 of 75 patients had significant pathological findings explaining their clinical disorders. Diagnostic yield was therefore 66. 6%. Findings consisted of angiodysplasia (21 patients), inflammatory small-bowel disease (16 patients), small-bowel polyps (5 patients), GI stromal tumor (2 patients), carcinoid tumor with lipoma (1 patient), lymphoma (1 patient) , submucosal lesions (3 patients) and diverticulum (1 patient). The images displayed were considered to be good. Conclusions:Capsule endoscopy is useful for evaluating suspected small intestinal diseases, especially the obscure gastrointestinal bleeding.