胶囊内镜诊断不明原因消化道出血107例

目的:探讨胶囊内镜在不明原因消化道出血中的诊断价值及其与双气囊小肠镜在病因诊断中联合应用的意义。方法:采用M2A胶囊内镜对107例不明原因消化道出血患者进行检查,其中男61例,女46例,平均年龄(51.6±18.9)岁。其中36例患者依据胶囊内镜所观察到的结果,选择经口或经肛行双气囊小肠镜检查和(或)手术探查。结果:107例患者中106例(99.1%)完成胶囊内镜检查,75例(70.8%)胶囊内镜通过回盲瓣。107例中病变检出96例(89.7%)、确诊70例(65.4%)。36例中再经双气囊小肠镜检查和(或)手术后证实胶囊内镜诊断者为26例(72.2%)。2例(1.9%)发生胶囊滞留。结论:胶囊内镜对不明原因消化道出血具有较高的诊断价值,可作为病因诊断的首选筛查手段,与双气囊小肠镜联合应用可大大提高疾病的确诊率。

Value of capsule endoscopy in the diagnosis of obscure gastrointestinal bleeding:an analysis of 107 cases

Objective To investigate the value of capsule endoscopy （CE） in the diagnosis of obscure gastrointestinal bleeding （OGIB） and the significance of the combined use of CE and double-balloon endoscopy （DBE） in etiological diagnosis. Methods One hundred and seven patients with OGIB 61 male/46 female, average age： （51.6±18.9） years] were enrolled in this study. CE was performed with Given M2A video capsule system. After being examined by the CE, and according to the results obtained from the CE, 36 patients had undergone DBE and/or operative exploration. Results Among the 107 patients, 106（99.1%） had completed the CE examination successfully. The endoscopic capsule passed the ileal valve in 75 cases （70.8%）. The detecting rate and diagnostic yield were 89.7% （n=96） and 65.4%（n=70）, respectively. Of the 36 patients performed DBE and/or operative exploration after CE, 26 （72.2%） patients had their diagnosis similar to that diagnosed by CE. Capsule retention occurred in 2 （1.9%） patients. Conclusions In OGIB, CE could provide a high diagnostic yield. It may be used as the first choice of diagnostic screening device in OGIB. CE when combined with DBE can increase the diagnostic yield of small bowel disease.