器官功能不全患者行胶囊内镜检查的肠道准备

Bowel preparation for capsule endoscopy in organ dysfunction patients

目的:探讨心、肺、肾等脏器功能不全的特殊患者行胶囊内镜检查时肠道准备的方法.方法:2007-09/2008-06我院收治的疑为小肠疾病的患者43例,分为A组:不伴有器官功能衰竭患者(磷酸盐口服液和大量清水),伴有器官功能不全患者随机分为B组(3d流质饮食,磷酸盐口服液和少量清水)和C组(3d禁食).观察患者的舒适性、肠道的清晰度以及肠腔充盈度等指标.结果:行特殊肠道准备的B组和C组,患者不适的发生率较A组明显减少,而B组和C组之间无差异.A、B两组患者小肠检查全程清洁度无差异.C组小肠清洁和较清洁的上半肠段与A、B两组上半小肠段比较无差异,而C组下半段小肠的肠腔清晰度与A、B两组比较有明显下降(12.6±3.6vs52.4±13.3,46.6±8.1;21.2±9.3vs46.4±11.2,49.7±9.3,均P<0.01);A、B两组患者肠腔充盈度比较无差异,而C组与A、B组比较,充盈度明显下降(24.4±4.8vs45.2±8.2,46.5±9.4,均P<0.01).结论:心肺肾等器官功能不全的患者可以进行胶囊内镜检查,检查时可以根据患者不同的检查目的选择合适的肠道准备方法.

AIM： To determine the bowel preparation for capsule endoscopy （CE） in patients with organ dysfunction.METHODS： Forty three patients suspected of bowel diseases in our hospital were included in this prospective study. Control group （Group A, without organ dysfunction or failure） were treated with sodium phosphate and enough water. Twenty three organ dysfunction patients were randomly assigned to group B （liquid diet for 3 d, less sodium phosphate and less water） and to group C （fasting 3 d and parenteral alimentation）. Indicators including the comfort, enteric visibility and extensity of patients were observed.RESULTS： Group B and group C, which showed no significant difference between themselves, had better comfort than group A during the examination. There was not significant difference in cleanness and visibility on CE in whole small bowel between group A and group B. Group C showed decreased visibility in low-er-half small bowel, but no difference in upperhalf small bowel, compared with group A and B （12.6 ± 3.6 vs 52.4 ± 13.3, 46.6 ± 8.1, 21.2 ± 9.3 vs 46.4 ± 11.2, 49.7 ± 9.3, all P 〈 0.01）. Extensity of group C was less than group A and group B （24.4 ± 4.8 vs 45.2 ± 8.2, 46.5 ± 9.4, both P 〈 0.01）.CONCLUSION： Capsule endoscopy can be performed on organ dysfunction patients. Accord-ing to location of diseases, appropriate bowel preparation is needed, for example, some laxa-tive and less water for whole small bowel, and 3 d fasting for upper-half small bowel.