胶囊内镜在慢性腹泻中的诊断价值

Value and safety of capsule endoscopy as a diagnostic tool in chronic diarrhea

目的分析胶囊镜在慢性腹泻中的诊断价值及进行安全性评估。方法收集2002年10月至2005年1月在上海瑞金医院进行胶囊内镜检查的慢性腹泻患者共24例(4女/20男,年龄39.67±9.41)及无消化道症状体检者80例(21女/59男,年龄46.43±10.26),进行诊断结果的相关统计性分析。结果在慢性腹泻患者中发现空肠-回肠多发性溃疡5例(20.83%),回肠黏膜糜烂2例(8.33%),空肠增殖性病灶1例(4.17%),小肠血管畸形1例(4.17%);无消化道症状的体检者中发现回肠息肉2例(2.50%),小肠血管畸形2例(2.50%),小肠黏膜糜烂1例(1.25%),空肠孤立性溃疡1例(1.25%)。两组检查后胶囊均能顺利排出。小肠疾病在慢性腹泻患者中的患病率(37.50%)明显高于无消化道症状的体检者(7.50%),两者相较有明显的统计学意义(P<0.01)。结论胶囊内镜对慢性腹泻的诊断有重要的参考的价值,临床安全性好。

Aim The aim of the study is to evaluate value and safety of capsule endoscopy as a diagnostic tool in chronic diarrhea. Methods Between Oct. 2002 and Jan. 2005, 104 capsule endoscopy procedures were performed in 24 patients with chronic diarrhea （4F/20M, age 39.67 ＋_ 9.41） and 80 asymptomatic controls （21F/59M,age：46.43 ＋ 10.26）.Diagnoses by capsule endoscopy were recorded and compared statistically. Results The findings in chronic diarrhea group included 5 cases of jejuno-ileal ulcers（20.83% ）, 2 cases of ileal erosion（8.33% ）, 1 case of angiodysplasia（4.17% ）, and 1 case of jejunal neoplasm（4.17% ）.The findings in asymptomatic control group included 2 cases of ileal polyp （2.50%）, 2 cases of angiodysplasia（2.50 % ）, 1 case of intestinal erosion（ 1.25 % ）, and 1 case of jejunal ucler（ 1.25 % ）. All of capsules eventually passed out spontaneously after procedures. Comparison of 2 groups, prevalence in chronic diarrhea is significantly higher than that in asymptomatic control（ P 〈 0.01 ）. Conclusion Capsule endoscopy is a safe procedure and valuable tool in diagnosing chronic diarrhea.