胶囊内镜检查临床分析

Clinical Analysis of Capsule Endoscopy

目的研究胶囊内镜对消化道疾病的诊断价值。方法检查前2d,要求患者进食无渣食物,检查前1d中午和晚上,患者分别取20g番泻叶用开水泡茶服2～3杯,晚上要求患者进食全流食物或禁食,检查当日晨禁食,用20%甘露醇250ml,5%糖盐水1000ml及纯净水1000～1500ml口服,在1～1.5h内服完。吞服胶囊前30min可服用10%的二甲基硅油(消泡剂)50ml,30min后干咽或者用100ml清水吞服胶囊;然后,在实时监控下,观察食道和胃的病变情况;胶囊进入十二指肠后患者可携带图像记录仪离开医院。结果112例中发现有消化道病变者105例(1例患者可发生多种疾病),阳性检出率占93.7%。其中食道炎13例,食道息肉2例,糜烂性胃炎35例,胃溃疡17例,胃息肉12例,胆汁反流24例,十二指肠溃疡9例,小肠息肉5例,小肠血管异常11例,小肠炎19例,克罗恩病5例,肠道钩虫2例,结肠息肉18例,结肠癌1例,结肠粘膜黑变病6例。结论胶囊内镜图像清晰,操作简便,无副反应,胶囊内镜对消化道疾病具有较好的诊断效果,特别适用于小肠疾病和不明原因消化道出血患者的诊断。

Objective To Research the diagnostic value of capsule endoscope in digestive tract examination.Methods Let the patient eat food without residue during the first two days of the examination.Take 20 grams of senna tea served with 2~3 cups boiling water at the noon and the evening of the day before the examination.The patient should eat liquid whole food or fast food in the evening.Fasting in the morning of examination day.On the examination day,the patient should take 20% mannitol 250ml,5% sugar saline 1 000 ml and purified water 1 000 - 1 500mt orally in 1 - 1.5hours. Patients may take 10% dimethyl silicone oil （antifoaming agent） 50ml before they swallow the capsule. Then,under the real - time monitoring to observe the esophagus and stomach lesions. After the capsule entered the duodenal, patients could leave the hospital with the image recorder. Results 105 of 112 patients （93.7%） found the lesion, including inflammatory esophagitis in 13 cases, esophagus polyp in 2 cases, gastric ulcers in 17 cases, duodenal ulcer in 9 cases, erosive gastritis in 35 cases,gastric polyp in 12 cases, gastro esophageal reflux in 24 cases, small intestinal polyps in 5 cases, small intestinal vessel abnormality in 11 cases, enteritis in 19 cases, Crohn＇s disease in 5 cases ; anchylostomum in 2 cases;colitis polyp in 18 cases,melanosis coli in 6 cases. Conclusion Capsule endoscope has the better diagnosis effect in small intestinal diseases, especially for the patients with obscure bleeding.