无线胶囊内镜在消化道疾病诊断中的应用分析

Study on value of wireless capsule endoscope in diagnosis of digestive tract disease

目的探讨无线胶囊内镜在消化道疾病诊断中的价值和安全性。方法对14例不明原因的消化道出血、腹痛和慢性腹泻患者进行Given M2A胶囊内镜检查,并与14例患者的传统检查(胃镜、结肠镜、全消化道钡餐或选择性腹腔动脉造影)进行对比分析,探究Given M2A胶囊内镜在消化道疾病中的诊断价值和安全性。结果胶囊内镜检查过程中所有病例无任何不适和并发症,所有受检者均顺利完成检查。所得图像清晰。13例发现病变,检出胃部疾病6例(慢性胃炎、胆汁反流性胃炎、胃、十二指肠溃疡),小肠疾病6例(息肉、肿块、血管病变、憩室、溃疡、炎症),结肠炎1例。2例不明原因的腹痛中1例未发现病变。4例不明原因的便血和腹泻2例经胶囊内镜检查发现有意义的小肠病变,其中1例空肠肿块行手术治疗,手术证实胶囊内镜诊断及定位准确。2例消化性溃疡(1例复合性溃疡、1例十二指肠溃疡)和3例慢性胃炎患者胶囊内镜检查结果与胃镜相比,3处溃疡中有1处球部溃疡未检出,发现1例当地胃镜未检出的球部溃疡;1例体检者发现慢性结肠炎。结论胶囊内镜采集图像清晰,安全性好,对病变的检出率高,定位较准确。尤其适合于小肠疾病的诊断,对胃部病变也有一定的诊断价值。因此,胶囊内镜以其无创、确诊率较高的特点易被患者接受。

Objective: To evaluate the detection rate and safety of M2A wireless capsule endoscope in the diagnosis of digestive tract disease. Methods: Fourteen patients,suffered from unexplained gastrointestinal bleed, abdominal pain and chronic diarrhea were referred to this study and underwent capsule endoscope. Compared the results of CE with that of the conventional diagnostic procedures(including gastroscope, colonoscope,digestive tract barium meal and digital subtraction anglography of selective celiac artery), to assess the detection rate and safety of M2A wireless capsule endoscope in the diagnosis of digestive tract disease. Results: All the cases had completed CE successfully, any complication never experienced.The quality of photos was excellent. The pathological finding was revealed in thirteen cases,the diagnostic yield was therefore 92.9%. The patients with gastric disease, intestinal disease,colon disease were 6,6 and 1 respectively. One in the two cases with obscure abdominal pain had no abnormal finding. All of six cases with unexplained gastrointestinal bleed and chronic diarrhea were detected significant intestinal disease, one case among these underwent jejunum tumor resection, and operation and pathological examine verified the diagnosis was accurate.Two patients with peptic ulcer and three with chronic gastritis underwent CE voluntarily, the results indicated that CE detected two lesion among three ulcer lesion,and found one ulcer lesion which were not be detected by gastroscope in the junior hospital;one case of health examination were found colon inflammation disease by CE. Conclusion: CE has the advantages of excellent visualization,high safety and detected rate, precise localization, which is especially suit to diagnosis of the intestinal disease and has diagnostic value to gastric disease to some extent. Therefore, CE is a indispensable means in diagnosis of digestive tract disease, compared with other conventional procedure.