摘要
背景:不明原因消化道出血(OGIB)的诊断是临床难题之一。随着内镜技术的革新,OGIB的诊治水平不断提高。目的:评价胶囊内镜诊断OGIB的价值。方法:回顾性分析南京鼓楼医院2003年5月~2008年4月行胶囊内镜检查的OGIB患者的资料。结果:胶囊内镜的OGIB总检出率为82.6%(228/276)。小肠病变检出率为77.5%(214/276),其中以血管动静脉畸形(AVM)最为常见,其次为小肠占位和小肠克罗恩病(CD)。14例(5.1%)患者的出血部位位于小肠以外,其中5例位于胃内,9例为结肠病变。所有患者均未出现肠梗阻症状。与<50岁的患者相比,≥50岁者的小肠AVM检出率显著增高(33.9%对19.6%,P=0.016),小肠占位和寄生虫病检出率均无明显差异。男性患者的小肠CD检出率显著高于女性患者(17.1%对6.8%,P=0.018)。结论:胶囊内镜检查安全、无创伤,诊断OGIB的价值较高。OGIB以小肠AVM最为多见,其次为小肠占位和CD。
Background: Diagnosis of obscure gastrointestinal bleeding (OGIB) is one of the most difficult problems clinically. The diagnosis and treatment of OGIB have been continuously improved since the innovation of endoscopy. Aims: To evaluate the value of capsule endoscopy in the diagnosis of OGIB. Methods: Data of OGIB patients undergone capsule endoscopy in Nanjing DrumTower Hospital from May 2003 to April 2008 were reviewed retrospectively. Results: The overall detection rate of OGIB by capsule endoscopy was 82.6% (228/276), that of small intestinal lesions was 77.5% (214/276). Of all the small intestinal lesions, arteriovenous malformation (AVM) was most common, followed by small intestinal space-occupying lesion, and Crohn's disease (CD). Five cases had lesions within the stomach and 9 were in the colon. Bowel obstruction was not found in any patients. The detection rate of intestinal AVM in ≥ 50-year-old patients was significantly higher than that in 〈50-year-old patients (P=0.016), while no significant differences were found in detection rates of small intestinal space-occupying lesion and parasitic disease between ≥50-year-old patients and 〈50-year-old patients. Detection rate of small bowel CD in male patients was significantly higher than that in female patients (17.1% vs. 6.8%, P=0.018). Conclusions: Capsule endoscopy has the advantages of safety, non-invasiveness and higher diagnostic value in the detection of OGIB. AVM is the most commonly seen cause of OGIB, followed by small intestine spaceoccupying lesion and CD.
出处
《胃肠病学》
2009年第9期543-546,共4页
Chinese Journal of Gastroenterology
关键词
胶囊内镜
不明原因消化道出血
诊断
动静脉畸形
Capsule Endoscopes
Obscure Gastrointestinal Bleeding
Diagnosis
Arteriovenous Malformations