不同类型胶囊内镜对消化道疾病诊断价值的探讨

  目的  探讨胶囊小肠镜与磁控胶囊胃镜应用于消化道疾病诊断中的临床价值。  方法  选取于蚌埠医学院第一附属医院消化内科行胶囊内镜检查患者共154例，对其临床资料进行回顾性分析，分析胶囊内镜检查可行性及疾病检出情况，并对胶囊小肠镜组患者不同性别、年龄、主要临床症状组间小肠疾病检出差异进行统计学分析。  结果  所有行胶囊内镜检查患者均顺利完成消化道主要部位检查并采集图像，最终在2周内顺利排出，仅1例老年患者在磁控胶囊胃镜检查过程中出现不良反应，后自行缓解。磁控胶囊胃镜组消化道疾病总体检出率96.6%(85/88)高于胶囊小肠镜组78.8%(52/66)，差异有统计学意义(P < 0.05)；胶囊小肠镜组在小肠疾病的检出率71.2%(47/66)高于磁控胶囊胃镜组21.6%(19/88)，差异有统计学意义(P < 0.05)；胶囊小肠镜组消化道出血组的小肠病变检出率95.7%(22/23)远高于其他症状组，差异有统计学意义(P < 0.05)；磁控胶囊胃镜组在胃部病变检出率为90.9%(80/88)，在小肠病变检出率为21.6%(19/88)，小肠部位以糜烂性病变42.1%(8/19)、溃疡性病变31.6%(6/19)为主。  结论  胶囊小肠镜与磁控胶囊胃镜均为消化道疾病筛查的重要方式，胶囊小肠镜对小肠疾病尤其是小肠出血病变有较高的诊断价值；磁控胶囊胃镜不仅对胃部疾病检出率较高，对于提高小肠疾病的诊断效能也有一定意义。 

Diagnostic value of different types of capsule endoscopy in digestive tract diseases

  Objective  To compare the clinical value of small bowel capsule endoscopy (SBCE) and magnetically controlled capsule endoscopy (MCE) in the diagnosis of digestive tract diseases.  Methods  A total of 154 patients who underwent capsule endoscopy in the Department of Gastroenterology of our hospital were selected, and the clinical data were analyzed retrospectively. The feasibility and detection of diseases of capsule endoscopy were analyzed, and the differences of small intestinal diseases among SBCE patients with different gender, age and main clinical symptoms were analyzed.  Results  All the patients who underwent capsule endoscopy successfully completed the examination of the main parts of digestive tract and collected images, which were finally discharged smoothly within 2 weeks. Only one elderly patient developed adverse reactions during the magnetic capsule endoscopy and then self-relieved. The overall detection rate of digestive tract diseases in the MCE group was 96.6% (85/88) higher than that in the SBCE group 78.8% (52/66), and the difference was statistically significant (P < 0.05). The detection rate of small intestinal diseases in SBCE group was 71.2% (47/66) higher than that in MCE group 21.6% (19/88), and the difference was statistically significant (P < 0.05). The detection rate of intestinal lesions in SBCE group with gastrointestinal bleeding was 95.7% (22/23) higher than that in other symptom groups, and the difference was statistically significant (P < 0.05). In MCE group, the detection rate of gastric lesions was 90.9% (80/88), while that of small intestine lesions was 21.6% (19/88). And erosive lesions were 42.1% (8/19) and ulcerative lesions were 31.6% (6/19) in small intestine lesions.  Conclusion  SBCE and MCE are both important ways to screen digestive tract diseases.SBCE has high diagnostic value for small intestinal diseases, especially for small intestinal bleeding. MCE not only has a high detection rate for stomach diseases, but also has certain significance in diagnosis of small intestine diseases.