胶囊内镜对不明原因消化道出血患者临床诊断价值

Clinical value of capsule endoscopy in obscure gastrointestinal bleeding

目的:探讨胶囊内镜对不明原因消化道出血的诊断价值。方法:应用M 2A胶囊内镜检查系统对90例经胃镜、肠镜检查阴性的消化道出血患者进行检查。结果:90例不明原因消化道出血患者共进行92次胶囊内镜检查,检查成功率为94.57%(87/92),其中急性大量出血组检查成功率为84.0%(21/25),慢性显性出血组检查成功率为98.51%(66/67),两者经χ2检验有显著性差异(P<0.05)。在检查成功的患者中,胶囊内镜的病变检出率为85.06%,假阴性率17.24%。急性大量出血组病变检出率80.95%,假阴性率23.81%;慢性显性出血组病变检出率86.36%,假阴性率15.15%,经χ2检验均无显著性差异(P>0.05)。结论:胶囊内镜对不明原因消化道出血有较高的检出率,可以作为小肠出血的首选检查方法。

Objective： To investigate clinical diagnostic value of capsule endoscopy in obscure gastrointestinal bleeding. Methods： Capsule endoscopy were performed in 90 patients with obscure gastrointestinal bleeding, which was defined as negative finding by gastroscopy and colonoscopy in our hospital. Results： In 90 patients, 2 of them accepted second examination. Eighty-seven of 92 （94.57%） patients accepted of capsule endocopy successfully including 21 of 25 （84.0%） in group of acute massive bleeding and 66 of 67（98.51%） in recurrent melena （P〈 0.05）. In above patients,74 of 87 （85.06%） had positive findings and the false negative rate was 17.24%. The detectable rate in acute massive bleeding and recurrent melena was 80.95% and 86.36 %, respectively （P〉0.05）,and the false negative rate of that was 23.81% and 15. 15 %, respectively （P〉0. 05）. Conclusion： Capsule endoscopy can be performed safely and well- toleratedly for visualizing the small bowel in patients with obscure gastrointestinal bleeding, which induces a highly detectable rate compared with other methods for detecting obscure gastrointestinal bleeding.