智能胶囊式测压系统在结肠传输功能测定中的应用

Applications of a gastrointestinal monitoring microsystem based on the smart capsule in measuring the pressure of colon and the transmission function of colon

目的探讨智能胶囊式测压系统应用于慢传输性便秘患者结肠压力和传输功能测定中的作用和意义。方法试验分两组:健康组为健康志愿者30例;便秘组为慢性传输性便秘(STC)患者30例。两组均在9AM口服智能胶囊,12AM和6PM进食以刺激胃结肠反射;每隔7 h腹部超声检查了解智能胶囊的位置,胶囊随粪便自然排出体外后为完成检查。检测指标:胶囊在体内总时间、通过结肠时间、高幅传输波(HAPCs)总数、群发HAPCs、平均收缩幅度和生理响应比。结果所有受检者顺利吞服和自然排出智能胶囊,无任何不适感,胶囊外封硅胶均无破损。与健康组比较,便秘组的胶囊在体总时间、结肠通过时间明显延长,依次为(110.2±13.0)h vs.(29.7±6.5)h,(86.4±15.0)hvs.(14.8±4.6)h,(P=0.000和0.000);HAPCs总数、群发HAPCs较健康组明显减少分别为(12.4±3.4)vs.(18.9±3.5);(4.5±2.8)vs.(12.3±2.1),(P=0.012和0.004),平均收缩幅度和生理响应比显著低于健康组分别为(8.7±0.5)kPa vs.(9.5±0.7)kPa,42.10%vs.64.50%(P=0.026和0.024)。结论智能胶囊式测压系统是一种无创、安全、方便、符合生理功能的检测方法,不仅可检测全结肠动力和传输时间,而且可对便秘的产生及严重程度判断提供有力证据。

Objective To evaluate the effect and significance of the smart capsule monitoring system in measuring the pressure of colon and the transmission function of colon in patients with slow transit constipation. Methods The smart capsule monitoring system, which was manufactured by ourselves, was taken by 30 healthy volunteers and 30 patients with slow transit constipation. In all the cases, the smart capsule was taken orally at 9：00, and something was eaten at 12：00 and 18：00 in order to stimulate gastrocolic reflex. From 9 o＇clock, ultrasound was used to locate the position of the smart capsule every 7 hours until the capsule was eliminated from the body moved by stool. The main parameters of observation were the time of the capsule remaining in the body, time of the capsule passing through the colon, total high amplitude propagated contractions （ HAPCs ） , cluster HAPCs , average contraction amplitude and physiological response rate. Results All the cases that took the oral smart capsules eliminated the capsules in stool naturely, and without any discomfort. The silicon envelopes of the capsules were not broken. In constipation group, the time for the capsule remaining in the body and passing through the colon was longer than those in the healthy volunteer group [ （110.2 ±13.0）h vs. （29.7 ±6.5）h, （86.4 ±15.0）h vs. （14.8 ± 4.6 ） h, the P value was 0. 000 and 0. 000 , respectively ]. The total number of HAPCs and constitutional waves were both less than those in the healthy volunteer group [ （12.4±3.4） vs. （18.5±3.7）, （4.5±2.8） vs. （12.3 ±2. 1）, the P value was0.012 and 0.004, respectively] ; The average contraction amplitude and physiological response rate were both lower than those in the healthy group [ （ 8.7 ± 0.5 ） kPa vs. （9.5 s0.7） kPa, （42. 10% vs. 63.60%）, the P value was 0.028 and 0.012, respectively]. Conclusions The smart capsule monitoring system is a non-traumatic, safe, convenient, and physiological method. It not only can measure the dynamics of the total colonic tract and its transmission time, but also can provide strong evidence to assess the cause of constipation and its severity.