胶囊内镜在小肠疾病诊断中的应用

目的：探讨胶囊内镜在小肠疾病诊断中的应用价值和安全性。方法：对81例不明原因的消化道出血和腹痛患者行Given M2A胶囊内镜检查，分析其临床资料。结果：81例患者中9例胶囊内镜检查未发现明显异常，1例胶囊内镜未进入小肠，其余71例共发现小肠病变132处，小肠病变检出率88.75%。这些小肠病变包括炎症36例，血管病变24例，隆起性病变16例，息肉15例，小肠内血液覆盖12例，溃疡11例，小肠蛔虫6例，憩室5例，克罗恩病5例，钩虫病1例，小肠发育不良畸形并内瘘1例。胶囊内镜诊断的5例间质细胞瘤均经手术后病理证实，而克罗恩病、淋巴瘤、血管瘤等隆起性病变在胶囊内镜均未能正确诊断。胶囊内镜获取的图像质量良好。患者无明显并发症发生。结论：胶囊内镜对小肠疾病检出率较高、安全性好，但定性诊断能力有限，是一种安全有效的小肠疾病诊断的筛查方法。

Capsule endoscopy in the diagnosis of intestinal diseases

ObjectiveTo determine the efficiency and safety of capsule endoscopy for patients with intestinal diseases. MethodsGiven M2A capsule endoscopy (CE) was performed on 81 patients with obscure gastrointestinal bleeding and obscure abdominal pain, and the clinical data were analyzed. Results In the 81patients, 9 showed negative finding, CE didn’t reach the small intestine in 1 patient. In the other 71 patients, 132 intestinal lesions were detected, and the total positive rate of CE for intestinal diseases was 88.75%. The findings consisted of 36 intestinal inflammation, 24 angiopathy, 16 protuberant lesions, 15 mutipolypi in the intestine, 12 blood in the intestine, 11 single or multiple ulcers, 6 ascarid in the intestine, 5 diverticula, 1 ankylostomiasis, 1 intestinal dysplasia with internal fistula, and the 5 intestinal Crohn’s disease. Ten patients with protuberant lesion were verified by surgical operation and pathology, and the 5 stromal tumors diagnosed by CE were confirmed by pathological examination, while no one of Crohn’s disease, lymphoma and angioma was diagnosed correctly by CE. All images of CE were good. All the patients had no complications. ConclusionCapsule endoscopy is a safe and effective procedure, with a high positive rate，but the diagnostic yield is limited, which can be used for intestinal diseases.