胶囊内镜对不明原因消化道出血的诊断价值研究

Diagnostic Yield of Capsule Endoscopy in a Large Cohort of Patients with Obscure Gastrointestinal Bleeding

目的不明原因消化道出血是胶囊内镜检查的最常见入选指征之一。本研究拟通过分析大样本不明原因消化道出血(OGIB)患者中胶囊内镜的检查结果以探讨胶囊内镜在其中的诊断价值。方法回顾性分析2002年5月至2007年2月间因OGIB入选我院胶囊内镜检查的患者共215例,分析其一般资料、出血类型及检查结果。结果共纳入OGIB患者215例,其中男性111例,女性104例,平均年龄54.2±19.1(3～87)岁,共143例(67.1%)获阳性结果。根据出血类型分为显性出血者197例,隐性出血者18例,组间平均年龄、病程和检查次数及阳性诊断率比较均无统计学差异。血管发育异常为最常见病因,其次为小肠克罗恩病和小肠恶性肿瘤。结论胶囊内镜在OGIB患者中阳性诊断率为67.1%,显性出血和隐性出血组间阳性发现率无统计学差异,血管发育异常为最常见病因。

Objective：Obscure gastrointestinal bleeding （OGIB） is one of the most frequent indication for capsule endoscopy （CE）. The objective of the study was to determine the diagnostic yield of CE in a large cohort of patients with OGIB. Methods： The study is a retrospective analysis of patients referred to our hospital from May 2002 to February 2007 for the investigation of OGIB who underwent CE. Demographic, clinical, diagnostic data were collected for analysis. Results： Two hundred fifteen patients （ 111 men and 104 women ） were studied, with a mean age of 54.2 yr. A total of 143 patients obtained positive findings. One hundred and ninety-seven patients presented with overt OGIB while eighteen patients had occult OGIB. No significance was seen in the demographic, clinical, positive diagnostic data between two groups. Angiodysplasias were the most frequent lesions identified. Crohn＇s disease and malignant tumor of small intestine were less frequently seen. Conclusion： The yield of positive findings on CE in patients with OGIB was 67.1%and no significant difference was seen between the overt OGIB group and the occult OGIB group. Angioectasias account for the majority of positive findings in both groups.